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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.”
BackgroundINTRACELLULAR ACTIVITIES AND EVOKED POTENTIAL CHANGES DURING POLARIZATION OF MOTOR CORTEX.
Purpura, D., & McMurtry, J. G. (1965) · Journal of Neurophysiology · doi:10.1152/jn.1965.28.1.166 · Cited by 875 · cited 1×
“The exposed tissue is polarized and tDCS modifies spontaneous neuronal excitability and activity by a tonic de- or hyperpolarization of resting membrane potential.(17,18) The efficacy of tDCS to induce acute modifications of membrane polarity depends on current density, which determines the induced electrical field st…”
BackgroundModeling the current distribution during transcranial direct current stimulation
Miranda, P. C., Lomarev, M. P., & Hallett, M. (2006) · Clinical Neurophysiology · doi:10.1016/j.clinph.2006.04.009 · Cited by 797
Shaping the Effects of Transcranial Direct Current Stimulation of the Human Motor Cortex
Nitsche, M. A., Dömkes, S., Karaköse, T., Antal, A., Liebetanz, D., Lang, N., Tergau, F., & Paulus, W. (2007) · Journal of Neurophysiology · doi:10.1152/jn.01312.2006 · Cited by 780 · cited 1×
“When compared with a large 35 cm(2)-sized electrode, the small electrode resulted in a much more spatially limited excitability modification.(27) However, the effects of small electrodes could differ qualitatively due to: (a) differential shunting of current in the scalp; (b) greater edgeeffect relative to the overall…”
ResultSelf-citationLang, N., Siebner, H. R., Ward, N., Lee, L., Nitsche, M. A., Paulus, W., Rothwell, J. C., Lemon, R., & Frackowiak, R. S. J. (2005) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2005.04233.x · Cited by 767
Self-citationLevel of action of cathodal DC polarisation induced inhibition of the human motor cortex
Nitsche, M. A., Nitsche, M. S., Klein, C. C., Tergau, F., Rothwell, J. C., & Paulus, W. (2003) · Clinical Neurophysiology · doi:10.1016/s1388-2457(02)00412-1 · Cited by 751 · 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., Seeber, A., Frommann, K., Klein, C. C., Rochford, C., Nitsche, M. S., Fricke, K., Liebetanz, D., Lang, N., Antal, A., et al. (2005) · The Journal of Physiology · doi:10.1113/jphysiol.2005.092429 · Cited by 744
Self-citationSiebner, H. R., Lang, N., Rizzo, V., Nitsche, M. A., Paulus, W., Lemon, R., & Rothwell, J. C. (2004) · Journal of Neuroscience · doi:10.1523/jneurosci.5316-03.2004 · Cited by 729
Self-citationProbing the human vestibular system with galvanic stimulation
Fitzpatrick, R. C., & Day, B. L. (2004) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00008.2004 · Cited by 700 · cited 1×
“Specifically, electrodes above the mastoids, which are used for galvanic stimulation of the vestibular system, might induce nausea.(51) Because tDCS neither causes epileptic seizures nor reduces the seizure threshold in animals,(52) seizures do not appear to be a risk for healthy subjects.”
BackgroundFregni, F., Boggio, P. S., Lima, M. C., Ferreira, M. J. L., Wagner, T., Rigonatti, S. P., de Castro, A. W., de Souza, D. R., Riberto, M., Freedman, S. D., et al. (2006) · Pain · doi:10.1016/j.pain.2006.02.023 · Cited by 694
Self-citationSafety and cognitive effect of frontal DC brain polarization in healthy individuals
Iyer, M. B., Mattu, U., Grafman, J. H., Lomarev, M. P., Sato, S., & Wassermann, E. M. (2005) · Neurology · doi:10.1212/01.wnl.0000152986.07469.e9 · Cited by 688 · cited 2×
“These parameters do not (1) cause heating effects under the electrode(13); (2) elevate serum neurone-specific enolase level,(14,15) a sensitive marker of neuronal damage(48); and (3) result in changes of diffusion weighted or contrast-enhanced magnetic resonance imaging (MRI), EEG activity, or cognitive distortion.(19…”
BackgroundSelf-citationBoggio, P. S., Ferrucci, R., Rigonatti, S. P., Covre, P., Nitsche, M. A., Pascual‐Leone, Á., & Fregni, F. (2006) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2006.05.062 · Cited by 642
Self-citationNitsche, M. A., Liebetanz, D., Antal, A., Lang, N., Tergau, F., & Paulus, W. (2003) · Supplements to Clinical neurophysiology · doi:10.1016/s1567-424x(09)70230-2 · Cited by 613
Self-citationTranscranial direct current stimulation of the unaffected hemisphere in stroke patients
Fregni, F., Boggio, P. S., Mansur, C. G., Wagner, T., Ferreira, M. J. L., Lima, M. C., Rigonatti, S. P., Marcolin, M. A., Freedman, S. D., Nitsche, M. A., et al. (2005) · Neuroreport · doi:10.1097/01.wnr.0000177010.44602.5e · Cited by 600
Self-citationBoggio, P. S., Rigonatti, S. P., Ribeiro, R. B., Myczkowski, M. L., Nitsche, M. A., Pascual‐Leone, Á., & Fregni, F. (2007) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145707007833 · Cited by 577
Self-citationPolarization of the human motor cortex through the scalp
Priori, A., Berardelli, A., Rona, S., Accornero, N., & Manfredi, M. (1998) · Neuroreport · doi:10.1097/00001756-199807130-00020 · Cited by 568 · cited 3×
“Because current orientation with respect to the target cells determines the effects of tDCS, results achieved by these protocols might differ from those with cephalic references.(13,16,20,21) Increasing focality of tDCS can be achieved by: (1) reducing electrode size, but keeping current density constant, for the elec…”
BackgroundMethodResultSelf-citationFregni, F., Gimenes, R. O., Valle, A. C., Ferreira, M. J. L., Rocha, R. R., Natalle, L., Bravo, R., Rigonatti, S. P., Freedman, S. D., Nitsche, M. A., et al. (2006) · Arthritis & Rheumatism · doi:10.1002/art.22195 · Cited by 568
Self-citationTranscranial direct current stimulation: A computer-based human model study
Wagner, T., Fregni, F., Fecteau, S., Grodzinsky, A., Zahn, M., & Pascual-Leone, A. (2007) · NeuroImage · doi:10.1016/j.neuroimage.2007.01.027 · Cited by 567 · cited 1×
“However, the effects of small electrodes could differ qualitatively due to: (a) differential shunting of current in the scalp; (b) greater edgeeffect relative to the overall electrode area (antagonistically oriented electric fields in the immediate vicinity of the electrodes(28)); and other factors.(23) For the motor…”
BackgroundSelf-citationInfluence of transcortical d-c currents on cortical neuronal activity
Creutzfeldt, O. D., Fromm, G. H., & Kapp, H. (1962) · Experimental Neurology · doi:10.1016/0014-4886(62)90056-0 · Cited by 555 · cited 3×
“Similarly, early animal experiments showed that surface-anodal tDCS enhanced and surface-cathodal tDCS reduced activity of superficial cortical neurons, whereas neurons situated deep in the cortical sulci, and thus differently oriented, were oppositely affected.(17) tDCS protocols should specify electrode position as…”
BackgroundResultTranscranial direct current stimulation during sleep improves declarative memory
Marshall, L., Mölle, M., Hallschmid, M., & Born, J. (2004) · The Journal of Neuroscience · doi:10.1523/jneurosci.2725-04.2004 · Cited by 548
Current Distribution in the Brain From Surface Electrodes
Rush, S., & Driscoll, D. A. (1968) · Anesthesia & Analgesia · doi:10.1213/00000539-196811000-00016 · Cited by 531 · cited 2×
“In monkeys, approximately 50% of the transcranially applied current enters the brain through the skull.(7) These estimates were confirmed in humans.”
BackgroundBoggio, P. S., Nunes, A., Rigonatti, S. P., Nitsche, M. A., Pascual‐Leone, Á., & Fregni, F. (2007) · Restorative Neurology and Neuroscience · doi:10.3233/rnn-2007-00375 · Cited by 523 · cited 1×
“Indeed, it was demonstrated that behavioral effects of tDCS could be increased and made stable by this procedure.(44,45) However, whether this protocol is optimally suited to maximize the electrophysiologic effects of tDCS is not known.”
BackgroundSelf-citationPriori, A. (2003) · Clinical Neurophysiology · doi:10.1016/s1388-2457(02)00437-6 · Cited by 507 · cited 2×
“004 Application of electrical currents to modify brain function is a very old technique, mentioned more than 200 years ago.(1,2) Systematic animal studies in anesthetized rats demonstrated that weak direct currents, delivered by intracerebral or epidural electrodes, induce cortical activity and excitability diminution…”
BackgroundSelf-citationTreatment of major depression with transcranial direct current stimulation
Fregni, F., Boggio, P. S., Nitsche, M. A., Marcolin, M. A., Rigonatti, S. P., & Pascual‐Leone, Á. (2006) · Bipolar Disorders · doi:10.1111/j.1399-5618.2006.00291.x · Cited by 495
Self-citationFecteau, S., Knoch, D., Fregni, F., Sultani, N., Boggio, P., & Pascual-Leone, A. (2007) · The Journal of Neuroscience · doi:10.1523/jneurosci.3283-07.2007 · Cited by 470
Self-citationTranscranial direct current stimulation improves recognition memory in Alzheimer disease
Ferrucci, R., Mameli, F., Guidi, I., Mrakic-Sposta, S., Vergari, M., Marceglia, S., Cogiamanian, F., Barbieri, S., Scarpini, E., & Priori, A. (2008) · Neurology · doi:10.1212/01.wnl.0000317060.43722.a3 · Cited by 448
Self-citationFecteau, S., Pascual-Leone, A., Zald, D. H., Liguori, P., Theoret, H., Boggio, P. S., & Fregni, F. (2007) · Journal of Neuroscience · doi:10.1523/jneurosci.0314-07.2007 · Cited by 446
Self-citationNoninvasive cortical stimulation with transcranial direct current stimulation in Parkinson's disease
Fregni, F., Boggio, P., Santos, M. C., Lima, M., Vieira, A. L., Rigonatti, S. P., Silva, M. T., Barbosa, E. R., Nitsche, M. A., & Pascual-Leone, Á. (2006) · Movement Disorders · doi:10.1002/mds.21012 · Cited by 444
Self-citationNoninvasive Brain Stimulation Improves Language Learning
Flöel, A., Rösser, N., Michka, O., Knecht, S., & Breitenstein, C. (2008) · Journal of Cognitive Neuroscience · doi:10.1162/jocn.2008.20098 · Cited by 443
Ardolino, G., Bossi, B., Barbieri, S., & Priori, A. (2005) · The Journal of Physiology · doi:10.1113/jphysiol.2005.088310 · Cited by 431 · cited 3×
“Moreover, cathodal tDCS increases power in the delta-and theta bands of the EEG. 40 Outside the motor cortex, electrophysiologic studies show analogous effects of anodal tDCS on somatosensory-evoked poten- tials, 41 and for anodal and cathodal tDCS on visual cortex stimulation.”
BackgroundInfluentialSelf-citationAntal, A., Nitsche, M., Kruse, W., Kincses, T. Z., Hoffmann, K., & Paulus, W. (2004) · Journal of Cognitive Neuroscience · doi:10.1162/089892904323057263 · Cited by 410
Self-citationImproved naming after transcranial direct current stimulation in aphasia
Monti, A., Cogiamanian, F. M., Marceglia, S. R. F., Ferrucci, R., Mameli, F., Mrakic‐Sposta, S., Vergari, M., Zago, S., & Priori, A. (2007) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.2007.135277 · Cited by 391
Self-citationGABAergic modulation of DC stimulation‐induced motor cortex excitability shifts in humans
Nitsche, M. A., Liebetanz, D., Schlitterlau, A., Henschke, U., Fricke, K., Frommann, K., Lang, N., Henning, S., Paulus, W., & Tergau, F. (2004) · European Journal of Neuroscience · doi:10.1111/j.0953-816x.2004.03398.x · Cited by 388
Self-citationOhn, S., Park, C.-I., Yoo, W., Ko, M.-H., Choi, K. P., Kim, G.-M., Lee, Y. T., & Kim, Y. (2008) · NeuroReport · doi:10.1097/wnr.0b013e3282f2adfd · Cited by 386
Consolidation of Human Motor Cortical Neuroplasticity by D-Cycloserine
Nitsche, M. A., Jaussi, W., Liebetanz, D., Lang, N., Tergau, F., & Paulus, W. (2004) · Neuropsychopharmacology · doi:10.1038/sj.npp.1300517 · Cited by 385
Self-citationAntal, A., Kincses, Z. T., Nitsche, M. A., Bártfai, O., & Paulus, W. (2004) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.03-0688 · Cited by 383 · cited 3×
“Because current orientation with respect to the target cells determines the effects of tDCS, results achieved by these protocols might differ from those with cephalic references.(13,16,20,21) Increasing focality of tDCS can be achieved by: (1) reducing electrode size, but keeping current density constant, for the elec…”
BackgroundResultSelf-citationBoggio, P. S., Sultani, N., Fecteau, S., Merabet, L., Mecca, T., Pascual-Leone, A., Basaglia, A., & Fregni, F. (2008) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2007.06.011 · Cited by 367
Self-citationOliphant, T. E., Manduca, A., Ehman, R. L., & Greenleaf, J. F. (2001) · Magnetic Resonance in Medicine · doi:10.1002/1522-2594(200102)45:2 · Cited by 361
Self-citationNitsche, M. A., Lampe, C., Antal, A., Liebetanz, D., Lang, N., Tergau, F., & Paulus, W. (2006) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2006.04676.x · Cited by 359
Self-citationAntal, A., Nitsche, M. A., Kincses, T., Kruse, W., Hoffmann, K., & Paulus, W. (2004) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2004.03367.x · Cited by 357
Self-citationKincses, T., Antal, A., Nitsche, M., Bártfai, O., & Paulus, W. (2004) · Neuropsychologia · doi:10.1016/s0028-3932(03)00124-6 · Cited by 340
Self-citationCogiamanian, F., Marceglia, S., Ardolino, G., Barbieri, S., & Priori, A. (2007) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2007.05633.x · Cited by 334
Self-citationLang, N., Siebner, H. R., Ernst, D., Nitsche, M. A., Paulus, W., Lemon, R., & Rothwell, J. C. (2004) · Biological Psychiatry · doi:10.1016/j.biopsych.2004.07.017 · Cited by 334
Self-citationEnhancement of non-dominant hand motor function by anodal transcranial direct current stimulation
Boggio, P. S., Castro, L. D. O., Savagim, E. A., Braite, R., Cruz, V. C., Rocha, R. R., Rigonatti, S. P., Silva, M. T. A., & Fregni, F. (2006) · Neuroscience Letters · doi:10.1016/j.neulet.2006.05.051 · Cited by 331
Self-citationLang, N., Nitsche, M. A., Paulus, W., Rothwell, J. C., & Lemon, R. (2004) · Experimental Brain Research · doi:10.1007/s00221-003-1800-2 · Cited by 315
Self-citationAge and sex differences in human motor cortex input–output characteristics
Pitcher, J. B., Ogston, K. M., & Miles, T. S. (2003) · The Journal of Physiology · doi:10.1113/jphysiol.2002.029454 · Cited by 307 · cited 2×
“An age dependency for tDCS efficacy has not been described so far, 37 but cannot be excluded at present, viz experience with TMS. 38 Uncontrolled interference with ongoing cortical activity during tDCS should be avoided.”
BackgroundAntal, A., Terney, D., Poreisz, C., & Paulus, W. (2007) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2007.05896.x · Cited by 306
Self-citationFregni, F., Orsati, F. T., Pedrosa, W., Fecteau, S., Tome, F. A. M. F., Nitsche, M. A., Mecca, T. P., de Macedo, E. C., Pascual‐Leone, Á., & Boggio, P. S. (2007) · Appetite · doi:10.1016/j.appet.2007.09.016 · Cited by 288
Self-citationFregni, F., Ligouri, P., Fecteau, S., Nitsche, M. A., Pascual‐Leone, Á., & Boggio, P. S. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0105 · Cited by 284
Self-citationFerrucci, R., Marceglia, S., Vergari, M., Cogiamanian, F., Mrakic-Sposta, S., Mameli, F., Zago, S., Barbieri, S., & Priori, A. (2008) · Journal of Cognitive Neuroscience · doi:10.1162/jocn.2008.20112 · Cited by 269 · cited 1×
“Alternatively, an extracephalic reference can be used to avoid the confounding effects of two electrodes with opposite polarities over the brain.(20,32) Because current orientation with respect to the target cells determines the effects of tDCS, results achieved by these protocols might differ from those with cephalic…”
BackgroundSelf-citationBoosting focally-induced brain plasticity by dopamine
Kuo, M.-F., Paulus, W., & Nitsche, M. A. (2008) · Cerebral Cortex · doi:10.1093/cercor/bhm098 · Cited by 269
Self-citationConsiderations for safety in the use of extracranial stimulation for motor evoked potentials
Agnew, W. F., & McCreery, D. B. (1987) · Neurosurgery · doi:10.1097/00006123-198701000-00030 · Cited by 265 · cited 1×
“Conventional electrical brain stimulation can cause excitotoxic damage to overdriven neurons.(46) This is not applicable to tDCS for the following reasons: (1) The effects of tDCS inducing changes in cortical excitability are most probably caused by a mild effect on cation channels and not being able to induce firing…”
BackgroundFregni, F., Boggio, P. S., Nitsche, M. A., Rigonatti, S. P., & Pascual‐Leone, Á. (2006) · Depression and Anxiety · doi:10.1002/da.20201 · Cited by 260
Self-citationBoggio, P. S., Bermpohl, F., Vergara, A. O., Muniz, A. L. C. R., Nahas, F. H., Leme, P. B., Rigonatti, S. P., & Fregni, F. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.10.026 · Cited by 258
Self-citationEffects of brain polarization on reaction times and pinch force in chronic stroke
Hummel, F., Voller, B., Celnik, P., Flöel, A., Giraux, P., Gerloff, C., & Cohen, L. (2006) · BMC Neuroscience · doi:10.1186/1471-2202-7-73 · Cited by 248
Self-citationEffects of transcranial direct current stimulation on the excitability of the leg motor cortex
Jeffery, D. T., Norton, J. A., Roy, F. D., & Gorassini, M. A. (2007) · Experimental Brain Research · doi:10.1007/s00221-007-1093-y · Cited by 248
External modulation of visual perception in humans
Antal, A., Nitsche, M., & Paulus, W. (2001) · NeuroReport · doi:10.1097/00001756-200111160-00036 · Cited by 240
Self-citationSparing, R., Dafotakis, M., Meister, I. G., Thirugnanasambandam, N., & Fink, G. R. (2007) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2007.07.009 · Cited by 233
Knoch, D., Nitsche, M. A., Fischbacher, U., Eisenegger, C., Pascual-Leone, A., & Fehr, E. (2008) · Cerebral Cortex · doi:10.1093/cercor/bhm237 · Cited by 229 · cited 1×
“029 mA/cm(2), made stimulation of this site functionally inert(27) and was used in previous behavioural studies.(30,31) As mentioned previously for smaller electrodes, enlarging the electrode might also affect shunting and current orientation.”
MethodSelf-citationManipulation of phosphene thresholds by transcranial direct current stimulation in man
Antal, A., Kincses, Z. T., Nitsche, M. A., & Paulus, W. (2003) · Experimental Brain Research · doi:10.1007/s00221-003-1459-8 · Cited by 228
Self-citationNitsche, M. A., Roth, A., Kuo, M., Fischer, A., Liebetanz, D., Lang, N., Tergau, F., & Paulus, W. (2007) · Journal of Neuroscience · doi:10.1523/jneurosci.5348-06.2007 · Cited by 227
Self-citationLiebetanz, D., Klinker, F., Hering, D., Koch, R., Nitsche, M. A., Potschka, H., Löscher, W., Paulus, W., & Tergau, F. (2006) · Epilepsia · doi:10.1111/j.1528-1167.2006.00539.x · Cited by 224
Self-citationHesse, S., Werner, C., Schonhardt, E. M., Bardeleben, A., Jenrich, W., & Kirker, S. G. B. (2007) · Restorative Neurology and Neuroscience · doi:10.3233/rnn-2007-00347 · Cited by 224
Lie-Specific Involvement of Dorsolateral Prefrontal Cortex in Deception
Priori, A., Mameli, F., Cogiamanian, F. M., Marceglia, S. R. F., Tiriticco, M., Mrakic‐Sposta, S., Ferrucci, R., Zago, S., Polezzi, D., & Sartori, G. (2007) · Cerebral Cortex · doi:10.1093/cercor/bhm088 · Cited by 223
Self-citationPremotor transcranial direct current stimulation (tDCS) affects primary motor excitability in humans
Boros, K., Poreisz, C., Münchau, A. M., Paulus, W., & Nitsche, M. A. (2008) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2008.06090.x · Cited by 215 · cited 1×
“For the motor cortex, it was shown that a smaller electrode modulates corticospinal excitability similarly to a larger one, but the effects on intracortical inhibition and facilitation were abolished and the variability of the effects was larger.(29) One means of reducing the effect of a cephalic reference electrode i…”
BackgroundSelf-citationFocusing Effect of Acetylcholine on Neuroplasticity in the Human Motor Cortex
Kuo, M., Grosch, J., Fregni, F., Paulus, W., & Nitsche, M. A. (2007) · Journal of Neuroscience · doi:10.1523/jneurosci.4104-07.2007 · Cited by 212
Self-citationFregni, F., Marcondes, R., Boggio, P. S., Marcolin, M. A., Rigonatti, S. P., Sánchez, T. G., Nitsche, M. A., & Pascual‐Leone, Á. (2006) · European Journal of Neurology · doi:10.1111/j.1468-1331.2006.01414.x · Cited by 210
Self-citationHomeostatic-like plasticity of the primary motor hand area is impaired in focal hand dystonia
Quartarone, A., Rizzo, V., Bagnato, S., Morgante, F., SantʼAngelo, A., Romano, M. C., Crupi, D., Girlanda, P., Rothwell, J. C., & Siebner, H. R. (2005) · Brain · doi:10.1093/brain/awh527 · Cited by 207
Catecholaminergic Consolidation of Motor Cortical Neuroplasticity in Humans
Nitsche, M. A. (2004) · Cerebral Cortex · doi:10.1093/cercor/bhh085 · Cited by 197
Self-citationMatsunaga, K., Nitsche, M., Tsuji, S., & Rothwell, J. (2004) · Clinical Neurophysiology · doi:10.1016/s1388-2457(03)00362-6 · Cited by 195
Self-citationVisual evoked potentials modulation during direct current cortical polarization
Accornero, N., Voti, P. L., Riccia, M. L., & Gregori, B. (2006) · Experimental Brain Research · doi:10.1007/s00221-006-0733-y · Cited by 188 · cited 3×
“Because current orientation with respect to the target cells determines the effects of tDCS, results achieved by these protocols might differ from those with cephalic references.(13,16,20,21) Increasing focality of tDCS can be achieved by: (1) reducing electrode size, but keeping current density constant, for the elec…”
BackgroundResultIncrease in the calcium level following anodal polarization in the rat brain
Islam, N., Aftabuddin, M., Moriwaki, A., Hattori, Y., & Hori, Y. (1995) · Brain Research · doi:10.1016/0006-8993(95)00434-r · Cited by 188 · cited 1×
“Subsequent studies revealed that the long-lasting effects are protein synthesisdependent(4) and accompanied by modifications of intracellular cAMP and calcium levels.(5,6) Thus, these effects share some features with the well-characterized phenomena of long-term potentiation (LTP) and long-term depression (LTD).”
BackgroundMental Changes Resulting from the Passage of Small Direct Currents Through the Human Brain
Lippold, O. C. J., & Redfearn, J. W. T. (1964) · The British Journal of Psychiatry · doi:10.1192/bjp.110.469.768 · Cited by 183
Antal, A., Brepohl, N., Poreisz, C., Boros, K., Csifcsák, G., & Paulus, W. (2008) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e318157233b · Cited by 179
Self-citationLimited impact of homeostatic plasticity on motor learning in humans
Kuo, M., Unger, M., Liebetanz, D., Lang, N., Tergau, F., Paulus, W., & Nitsche, M. A. (2008) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2008.02.023 · Cited by 176
Self-citationMechanisms for electrical stimulation of excitable tissue.
Roth, B. J. (1994) · PubMed · Cited by 175
Bifrontal transcranial direct current stimulation slows reaction time in a working memory task
Marshall, L., Mölle, M., Siebner, H. R., & Jan Born, A. (2005) · BMC Neuroscience · doi:10.1186/1471-2202-6-23 · Cited by 169
MRI study of human brain exposed to weak direct current stimulation of the frontal cortex
Nitsche, M. A., Niehaus, L., Hoffmann, K., Hengst, S., Liebetanz, D., Paulus, W., & Meyer, B.-U. (2004) · Clinical Neurophysiology · doi:10.1016/j.clinph.2004.05.001 · Cited by 168 · cited 1×
“These parameters do not (1) cause heating effects under the electrode(13); (2) elevate serum neurone-specific enolase level,(14,15) a sensitive marker of neuronal damage(48); and (3) result in changes of diffusion weighted or contrast-enhanced magnetic resonance imaging (MRI), EEG activity, or cognitive distortion.(19…”
BackgroundSelf-citationRoizenblatt, S., Fregni, F., Gimenez, R., Wetzel, T., Rigonatti, S. P., Tufik, S. B., Boggio, P. S., & Valle, A. C. (2007) · Pain Practice · doi:10.1111/j.1533-2500.2007.00152.x · Cited by 160
Self-citationDundas, J. E., Thickbroom, G. W., & Mastaglia, F. L. (2007) · Clinical Neurophysiology · doi:10.1016/j.clinph.2007.01.010 · Cited by 159 · cited 1×
“A recently conducted study suggests that a medium NaCl concentration (between 15 and 140 mM) is optimally suited to minimize discomfort.(25) Alternatively, electrode cream can be used to mount the electrodes on the head.”
BackgroundTranscranial direct current stimulation disrupts tactile perception
Rogalewski, A., Breitenstein, C., Nitsche, M. A., Paulus, W., & Knecht, S. (2004) · European Journal of Neuroscience · doi:10.1111/j.0953-816x.2004.03450.x · Cited by 159
Self-citationSex differences in cortical neuroplasticity in humans
Kuo, M., Paulus, W., & Nitsche, M. A. (2006) · Neuroreport · doi:10.1097/01.wnr.0000239955.68319.c2 · Cited by 156
Self-citationPrimary motor cortex activation by transcranial direct current stimulation in the human brain
Kwon, Y. H., Ko, M.-H., Ahn, S. H., Kim, Y., Song, J. C., Lee, C.-H., Chang, M. C., & Jang, S. H. (2008) · Neuroscience Letters · doi:10.1016/j.neulet.2008.02.012 · Cited by 149
Transcranial direct stimulation and fluoxetine for the treatment of depression
Rigonatti, S. P., Boggio, P. S., Myczkowski, M. L., Otta, E., Fiquer, J. T., Ribeiro, R. B., Nitsche, M. A., Pascual‐Leone, Á., & Fregni, F. (2007) · European Psychiatry · doi:10.1016/j.eurpsy.2007.09.006 · Cited by 147
Self-citationDieckhöfer, A., Waberski, T. D., Nitsche, M. A., Paulus, W., Büchner, H., & Gobbelé, R. (2006) · Clinical Neurophysiology · doi:10.1016/j.clinph.2006.07.136 · Cited by 145
Self-citationImprovement of spatial tactile acuity by transcranial direct current stimulation.
Ragert, P., Vandermeeren, Y., Camus, M., & Cohen, L. (2008) · Clinical Neurophysiology · doi:10.1016/j.clinph.2007.12.001 · Cited by 144
Self-citationFurubayashi, T., Terao, Y., Arai, N., Okabe, S., Mochizuki, H., Hanajima, R., Hamada, M., Yugeta, A., Inomata‐Terada, S., & Ugawa, Y. (2007) · Experimental Brain Research · doi:10.1007/s00221-007-1149-z · Cited by 139
Rosenkranz, K., Nitsche, M. A., Tergau, F., & Paulus, W. (2000) · Neuroscience Letters · doi:10.1016/s0304-3940(00)01621-9 · Cited by 133
Self-citationChaieb, L., Antal, A., & Paulus, W. (2008) · Visual Neuroscience · doi:10.1017/s0952523808080097 · Cited by 132
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Modulation of moving phosphene thresholds by transcranial direct current stimulation of V1 in human
Antal, A., Kincses, Z. T., Nitsche, M. A., & Paulus, W. (2003) · Neuropsychologia · doi:10.1016/s0028-3932(03)00181-7 · Cited by 124
Self-citationOscillatory brain activity and transcranial direct current stimulation in humans
Antal, A., Varga, E. T., Kincses, Z. T., Nitsche, M. A., & Paulus, W. (2004) · Neuroreport · doi:10.1097/01.wnr.0000127460.08361.84 · Cited by 110
Self-citationTranscranial Direct Current Stimulation Reveals Inhibitory Deficiency In Migraine
Chadaide, Z., Arlt, S., Antal, A., Nitsche, M. A., Lang, N., & Paulus, W. (2007) · Cephalalgia · doi:10.1111/j.1468-2982.2007.01337.x · Cited by 109
Self-citationA Controlled Trial of the Therapeutic Effects of Polarization of the Brain in Depressive Illness
Costain, R., Redfearn, J. W. T., & Lippold, O. C. J. (1964) · The British Journal of Psychiatry · doi:10.1192/bjp.110.469.786 · Cited by 102
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Durand, S., Fromy, B., Bouyé, P., Saumet, J., & Abraham, P. (2002) · The Journal of Physiology · doi:10.1113/jphysiol.2001.013364 · Cited by 97 · cited 1×
“The usually seen mild redness under the electrodes is not a hint of skin damage, but most probably caused by neurally driven vasodilation.(47) Theoretically, deposition of charge and electrolysis, generation of toxic ionic species, or modification of proteins and amino acids in brain tissue could also cause tissue dam…”
BackgroundPower, H. A., Norton, J. A., Porter, C. L., Doyle, Z., Hui, I., & Chan, K. M. (2006) · The Journal of Physiology · doi:10.1113/jphysiol.2006.116939 · Cited by 87
Intracerebral current levels in man during electrosleep therapy.
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Direct current stimulation over MT+/V5 modulates motion aftereffect in humans
Antal, A., Varga, E. T., Nitsche, M. A., Chadaide, Z., Paulus, W., Kovács, G., & Vidnyánszky, Z. (2004) · Neuroreport · doi:10.1097/00001756-200411150-00012 · Cited by 82
Self-citationLong lasting effects of transcranial direct current stimulation on motor imagery
Quartarone, A., Morgante, F., Bagnato, S., Rizzo, V., SantʼAngelo, A., Aiello, E., Reggio, E., Battaglia, F., Messina, C., & Girlanda, P. (2004) · Neuroreport · doi:10.1097/01.wnr.0000127637.22805.7c · Cited by 79
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Self-citationAntal, A., Lang, N., Boros, K., Nitsche, M. A., Siebner, H. R., & Paulus, W. (2008) · Cerebral Cortex · doi:10.1093/cercor/bhn032 · Cited by 72
Self-citationBidirectional modulation of primary visual cortex excitability: a combined tDCS and rTMS study.
Lang, N., Siebner, H., Chadaide, Z., Boros, K., Nitsche, M., Rothwell, J., Paulus, W., & Antal, A. (2007) · Investigative Ophthalmology and Visual Science · doi:10.1167/iovs.07-0706 · Cited by 71
Self-citationBrain polarization: behavioral and therapeutic effects.
Stepke, F. L. (1977) · PubMed · Cited by 68
Terney, D., Bergmann, I., Poreisz, C., Chaieb, L., Boros, K., Nitsche, M. A., Paulus, W., & Antal, A. (2008) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2007.08.014 · Cited by 63
Self-citationZago, S., Ferrucci, R., Fregni, F., & Priori, A. (2007) · The Neuroscientist · doi:10.1177/1073858407311101 · Cited by 57
Self-citationHuey, E. D., Probasco, J. C., Moll, J., Stocking, J., Ko, M.-H., Grafman, J. H., & Wassermann, E. M. (2007) · Clinical Neurophysiology · doi:10.1016/j.clinph.2007.02.026 · Cited by 41
Self-citationQuartarone, A., Lang, N., Rizzo, V., Bagnato, S., Morgante, F., SantʼAngelo, A., Crupi, D., Battaglia, F., Messina, C., & Girlanda, P. (2007) · Muscle & Nerve · doi:10.1002/mus.20737 · Cited by 36
Self-citationChapter 28 Modulation of motor consolidation by external DC stimulation
Lang, N., Nitsche, M. A., Sommer, M., Tergau, F., & Paulus, W. (2003) · Supplements to Clinical neurophysiology · doi:10.1016/s1567-424x(09)70231-4 · Cited by 23
Self-citationNegative polarisation of the brain in the treatment of manic states
Carney, M. W. P. (1969) · Irish Journal of Medical Science (1971 -) · doi:10.1007/bf02958921 · Cited by 21 · cited 1×
“Anodal stimulation was suggested to diminish depressive symptoms,(9) while cathodal stimulation reduced manic symptoms.(10) Unfortunately, these results were not replicated in follow-up studies performed in the United Kingdom, possibly because of different patient subgroups, inconsistent stimulation parameters, or oth…”
ResultVarga, E. T., Elif, K., Antal, A., Zimmer, M., Harza, I., Paulus, W., & Kovács, G. (2007) · PubMed · Cited by 21
Self-citationChapter 29 Pharmacology of transcranial direct current stimulation: missing effect of riluzole
Liebetanz, D., Nitsche, M. A., & Paulus, W. (2003) · Supplements to Clinical neurophysiology · doi:10.1016/s1567-424x(09)70232-6 · Cited by 11
Self-citationTranscranial direct current stimulation reveals inhibitory deficiency in migraine. Cephalalgia
Chadaide, Z., Arlt, S., Antal, A., Nitsche, M. A., Lang, N., & Paulus, W. (2007) · Cited by 5
Self-citation
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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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Physiological basis of transcranial direct current stimulation
Stagg, C. J., & Nitsche, M. A. (2011) · The Neuroscientist · doi:10.1177/1073858410386614 · Cited by 1,719
Self-citationBrunoni, A. R., Nitsche, M. A., Bolognini, N., Bikson, M., Wagner, T., Merabet, L., Edwards, D. J., Valero-Cabre, A., Rotenberg, A., Pascual-Leone, A., et al. (2012) · Brain stimulation · doi:10.1016/j.brs.2011.03.002 · Cited by 1,445
Self-citationAntal, A., Alekseichuk, I., Bikson, M., Brockmöller, J., Brunoni, A. R., Chen, R. E., Cohen, L. G., Dowthwaite, G., Ellrich, J., Flöel, A., et al. (2017) · Clinical Neurophysiology · doi:10.1016/j.clinph.2017.06.001 · Cited by 1,380
“…cm2, currents 1.5–2.1 mA) caused persisting skin lesions under the electrodes in some subjects, typically on the forehead or over frontal cortical areas (Frank et al. , 2010, Nitsche et al. , 2008, Palm et al. , 2008b, Riedel et al. , 2012, Rodriguez et al. , 2014, Wang et al. , 2015b) (Table 2).”
BackgroundInfluentialSelf-citationBrunoni, A. R., Amadera, J. E. D., Berbel, B., Volz, M. S., Rizzerio, B. G., & Fregni, F. (2011) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145710001690 · Cited by 1,219
Self-citationBatsikadze, G., Moliadze, V., Paulus, W., Kuo, M. ‐., & Nitsche, M. A. (2013) · The Journal of Physiology · doi:10.1113/jphysiol.2012.249730 · Cited by 1,017
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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