Cited by 415Transcranial Magnetic Stimulation StudiesElectroconvulsive Therapy StudiesDeep Brain Stimulation and Movement Disorders

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Therapeutic effects of non-invasive brain stimulation with direct currents (tDCS) in neuropsychiatric diseases

Kuo, Min-Fang, Paulus, Walter, Nitsche, Michael A.·2014·NeuroImage

DOI 10.1016/j.neuroimage.2013.05.117

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Abstract

Neuroplasticity, which is the dynamic structural and functional reorganization of central nervous system connectivity due to environmental and internal demands, is recognized as a major physiological basis for adaption of cognition, and behavior, and thus of utmost importance for normal brain function. Pathological alterations of plasticity are increasingly explored as pathophysiological foundation of diverse neurological and psychiatric diseases. Non-invasive brain stimulation techniques (NIBS), such as repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS), are able to induce and modulate neuroplasticity in humans. Therefore, they have potential to alter pathological plasticity on the one hand, and foster physiological plasticity on the other, in neuropsychiatric diseases to reduce symptoms, and enhance rehabilitation. tDCS is an emerging NIBS tool, which induces glutamatergic plasticity via application of relatively weak currents through the scalp in humans. In the last years its efficacy to treat neuropsychiatric diseases has been explored increasingly. In this review, we will give an overview of pathological alterations of plasticity in neuropsychiatric diseases, gather clinical studies involving tDCS to ameliorate symptoms, and discuss future directions of application, with an emphasis on optimizing stimulation effects.

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Background
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Background
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Background
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Background
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Background
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Background
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Background
Combined Bifrontal Transcranial Direct Current Stimulation and Tailor-Made Notched Music Training in Chronic Tinnitus
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Wang, Y., Wang, J., Zhang, Q., Xiao, K.-W., Wang, L., Yu, Q.-P., Xie, Q., Poo, M., & Wen, Y. (2022) · Neuroscience Bulletin · doi:10.1007/s12264-022-00901-1 · Cited by 34
“diseases to stroke-induced dysfunction (1-4).”
Effects of Transcranial Direct Current Stimulation With Sensory Modulation on Stroke Motor Rehabilitation: A Randomized Controlled Trial
Koh, C., Lin, J., Jeng, J., Huang, S., & Hsieh, C. (2017) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2017.05.025 · Cited by 33
Cerebellar Transcranial Direct Current Stimulation in Children with Autism Spectrum Disorder: A Pilot Study on Efficacy, Feasibility, Safety, and Unexpected Outcomes in Tic Disorder and Epilepsy
D’Urso, G., Toscano, E., Sanges, V., Sauvaget, A., Sheffer, C. E., Riccio, M. P., Ferrucci, R., Iasevoli, F., Priori, A., Bravaccio, C., et al. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm11010143 · Cited by 34
The Effects of Non-invasive Brain Stimulation on Impulsivity in People with Mental Disorders: a Systematic Review and Explanatory Meta-Analysis
Yang, C., Mauer, L., Vӧllm, B., & Khalifa, N. R. (2020) · Neuropsychology Review · doi:10.1007/s11065-020-09456-2 · Cited by 33
“In contrast, tDCS did not have a significant effect on impulsivity in patients with MDD although there is a growing body of evidence supporting its use to treat depressive symptoms (Kuo et al., 2014).”
Background
A Real-Time Phase-Locking System for Non-invasive Brain Stimulation
Mansouri, F., Fettes, P., Schulze, L., Giacobbe, P., Zariffa, J., & Downar, J. (2018) · Frontiers in Neuroscience · doi:10.3389/fnins.2018.00877 · Cited by 35
“While these methods have demonstrated applications in treating a number of neuropsychiatric disorders (Schulz et al., 2013; Kuo et al., 2014), they are still hampered by several important limitations.”
Method
Neural connectivity during affect labeling predicts treatment response to psychological therapies for social anxiety disorder.
Young, K. S., LeBeau, R. T., Niles, A. N., Hsu, K. J., Burklund, L. J., Mesri, B., Saxbe, D., Lieberman, M. D., & Craske, M. G. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.08.016 · Cited by 30
“Other methods of enhancing functional connectivity within this neural circuitry might also be investigated (e.g., transcranial direct current stimulation; Kuo et al., 2014) which may be particularly ef-”
A double‐blind sham‐controlled phase 1 clinical trial of tDCS of the dorsolateral prefrontal cortex in cocaine inpatients: Craving, sleepiness, and contemplation to change
Gaudreault, P., Sharma, A., Datta, A., Nakamura-Palacios, E. M., King, S. G., Malaker, P., Wagner, A., Vasa, D., Parvaz, M. A., Parra, L. C., et al. (2021) · European Journal of Neuroscience · doi:10.1111/ejn.15172 · Cited by 33
I h interacts with somato-dendritic structure to determine frequency response to weak alternating electric field stimulation
Toloza, E. H. S., Negahbani, E., & Frӧhlich, F. (2017) · Journal of Neurophysiology · doi:10.1152/jn.00541.2017 · Cited by 30
Poststimulation time interval-dependent effects of motor cortex anodal tDCS on reaction-time task performance
Molero‐Chamizo, A., Bailén, J. R. A., Béjar, T. G., López, M. G., Rodríguez, I. J., Lérida, C. G., Panal, S. P., Ángel, G. G., Corchero, L. L., Vega, M. J. R., et al. (2018) · Cognitive Affective & Behavioral Neuroscience · doi:10.3758/s13415-018-0561-0 · Cited by 31
The application of tDCS in psychiatric disorders: a brain imaging view
Baeken, C., Brunelin, J., Duprat, R., & Vanderhasselt, M. (2016) · Socioaffective Neuroscience & Psychology · doi:10.3402/snp.v6.29588 · Cited by 34
“Indeed, on the neurobiological level, schizophrenia has been associated with dysregulation of several neuromodulatory neurotransmitter systems, such as dopamine, consequently leading to pathological alterations of cortical activity and plasticity (Kuo et al., 2014).”
BackgroundMethodInfluential
Transcranial Electric Stimulation for Precision Medicine: A Spatiomechanistic Framework
Yavari, F., Nitsche, M. A., & Ekhtiari, H. (2017) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2017.00159 · Cited by 37
“Oscillations in the beta band have been linked to motor and sensorimotor functions and theta band waves are speculated to be involved in neural representations of hand kinematics (Notturno et al., 2014).”
Background
Behavioral and Neurophysiological Effects of Transcranial Direct Current Stimulation (tDCS) in Fronto-Temporal Dementia
Ferrucci, R., Mrakic‐Sposta, S., Gardini, S., Ruggiero, F., Vergari, M., Mameli, F., Arighi, A., Spallazzi, M., Barocco, F., Michelini, G., et al. (2018) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2018.00235 · Cited by 31
“Overall, data from studies on psychiatric disorders suggest that tDCS over the dorsolateral prefrontal cortex (DLPFC) (Brunoni et al., 2010, 2011; Kuo et al., 2014; D’Urso et al., 2017, 2018) has the potential to induce clinically relevant behavioral changes in difficult-totreat patient populations and could thus repr…”
Background
Timing matters: Transcranial direct current stimulation after extinction learning impairs subsequent fear extinction retention
Ney, L. J., Vicario, C. M., Nitsche, M. A., & Felmingham, K. L. (2020) · Neurobiology of Learning and Memory · doi:10.1016/j.nlm.2020.107356 · Cited by 33
Current and Emerging Therapies for Chronic Subjective Tinnitus
Park, K. W., Kullar, P., Malhotra, C., & Stanković, K. M. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12206555 · Cited by 29
“Non-invasive electrical stimulation techniques to modulate neural hyperactivity in speciﬁc brain areas include transcutaneous direct current stimulation (tDCS) and transcutaneous electrical stimulation (TENS) [103].”
Background
Use of transcranial direct current stimulation for the treatment of auditory hallucinations of schizophrenia – a systematic review
Ponde, P., de Sena, E. P., Camprodon, J. A., de Araújo, A. N., Ferrari-Neto, M., DiBiasi, M., Baptista, A. F., Moura, L. M. V. R., & Cosmo, C. S. A. (2017) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s122016 · Cited by 29
“Another type of synaptic neuroplasticity that appears to be influenced by tDCS is the type dependent on the brainderived neurotrophic factor, in which its dysfunction is associated with the maladaptive neuroplasticity phenomena present in various neuropsychiatric diseases, including schizophrenia.(1,16,17) During AVH,…”
Influential
Decoupling of interacting neuronal populations by time-shifted stimulation through spike-timing-dependent plasticity
Asl, M. M., Valizadeh, A., & Tass, P. A. (2023) · PLoS Computational Biology · doi:10.1371/journal.pcbi.1010853 · Cited by 29
“For instance, noninvasive stimulation of cortical regions can be realized by transcranial direct current stimulation (tDCS) or transcranial alternating current stimulation (tACS) which have shown promising effects on motor and cognitive functions in neuropsychiatric disorders [43, 45, 47].”
Would transcranial direct current stimulation (tDCS) enhance the effects of working memory training in older adults with mild neurocognitive disorder due to Alzheimer’s disease: study protocol for a randomized controlled trial
Cheng, C. P.-W., Chan, S. S. M., Mak, A. D. P., Chan, W. C., Cheng, S., Shi, L., Wang, D., & LAM, L. C. W. (2015) · Trials · doi:10.1186/s13063-015-0999-0 · Cited by 32
“The electrodes used for tDCS were 35 cm(2) in area [26].”
Method
Transcranial direct current stimulation as a treatment for auditory hallucinations
Koops, S., van den Brink, H., & Sommer, I. E. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00244 · Cited by 29
“…motor symptoms and working memory in Parkinson’s disease, on the amount of insults in epilepsy, on rehabilitation of motor function, and language disorder after stroke and on tinnitus (Floel, 2014; Kuo et al., 2014). tDCS is a safe treatment with few, if any, side effects (Nitsche et al., 2008).”
Background
Effect of microscopic modeling of skin in electrical and thermal analysis of transcranial direct current stimulation
Gomez-Tames, J. D., Sugiyama, Y., Laakso, I., Tanaka, S., Koyama, S., Sadato, N., & Hirata, A. (2016) · Physics in Medicine and Biology · doi:10.1088/1361-6560/61/24/8825 · Cited by 29
Electrical brain stimulation induces dendritic stripping but improves survival of silent neurons after optic nerve damage
Henrich‐Noack, P., Sergeeva, E. G., Eber, T., You, Q., Voigt, N., Köhler, J., Wagner, S., Lazik, S., Mawrin, C., Xu, G., et al. (2017) · Scientific Reports · doi:10.1038/s41598-017-00487-z · Cited by 31
Modulating neural plasticity with non-invasive brain stimulation in schizophrenia
Hasan, A., Wobrock, T., Rajji, T. K., Malchow, B., & Daskalakis, Z. J. (2013) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-013-0446-8 · Cited by 31
Visualizing simulated electrical fields from electroencephalography and transcranial electric brain stimulation: A comparative evaluation
Eichelbaum, S., Dannhauer, M., Hlawitschka, M., Brooks, D. H., Knösche, T. R., & Scheuermann, G. (2014) · NeuroImage · doi:10.1016/j.neuroimage.2014.04.085 · Cited by 28
“…through surface electrodes. tDCS has been known for over a century, but has recently been rediscovered as a promising tool to support a wide range of clinical applications (Boggio et al., 2006; Brunoni et al., 2012; Flöel, 2014; Kuo et al., 2014; Nitsche and Paulus, 2009; Schjetnan et al., 2013).”
Background
The Effects of Transcranial Direct Current Stimulation on Obsession-compulsion, Anxiety, and Depression of a Patient Suffering from Obsessive-compulsive Disorder
Alizadehgoradel, J., Pouresmali, A., Mowlaie, M., & Movahed, F. S. (2016) · Practice in Clinical Psychology · doi:10.15412/j.jpcp.06040201 · Cited by 28
Effects of transcranial direct current stimulation on motor skills learning in healthy adults through the activation of different brain regions: A systematic review
Qi, S., Liang, Z., Wei, Z., Liu, Y., & Wang, X. (2022) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2022.1021375 · Cited by 28
“Studies have demonstrated that tDCS can increase synaptic plasticity and enhance the functional connection of premotor, motor and sensorimotor regions (Kuo et al., 2014).”
Background
Short-term immobilization influences use-dependent cortical plasticity and fine motor performance
Opie, G. M., Evans, A., Ridding, M. C., & Semmler, J. G. (2016) · Neuroscience · doi:10.1016/j.neuroscience.2016.06.002 · Cited by 33
Transcranial direct current stimulation for upper limb neuropathic pain: A double‐blind randomized controlled trial
Lewis, G. N., Rice, D. A., Kluger, M. T., & McNair, P. J. (2018) · European Journal of Pain · doi:10.1002/ejp.1220 · Cited by 27
“Transcranial direct current stimulation (tDCS) is a noninvasive method of brain stimulation that can bidirectionally alter the excitability of cortical neurons under the electrodes (Nitsche and Paulus, 2000, 2001) and at connected sites (Lang et al., 2005).”
Method
Anodal Transcranial Direct Current Stimulation of Anterior Cingulate Cortex Modulates Subcortical Brain Regions Resulting in Cognitive Enhancement
Khan, A., Wang, X., Ti, C. H. E., Tse, C., & Tong, R. K. (2020) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2020.584136 · Cited by 28
Neuroglia in cognitive reserve
Verkhratsky, A., & Zorec, R. (2024) · Molecular Psychiatry · doi:10.1038/s41380-024-02644-z · Cited by 34
Anodal HD-tDCS on the dominant anterior temporal lobe and dorsolateral prefrontal cortex: clinical results in patients with mild cognitive impairment
Rezakhani, S., Amiri, M., Hassani, A., Esmaeilpour, K., & Sheibani, V. (2024) · Alzheimer s Research & Therapy · doi:10.1186/s13195-023-01370-y · Cited by 27
“The Neuroelectrics Instrument Controller (NIC2) software was used to create this figure feeling of pruritus and murmur but received no flow for the remaining 19 min [43].”
Method
Toward unraveling reading–related modulations of tDCS–induced neuroplasticity in the human visual cortex
Antal, A., Ambrus, G. G., & Chaieb, L. (2014) · Frontiers in Psychology · doi:10.3389/fpsyg.2014.00642 · Cited by 26
“Over the last 15 years transcranial direct current stimulation (tDCS) has become a promising tool in neuroplasticity research with perspectives in clinical neurophysiology (Nitsche and Paulus, 2011; Miniussi and Ruzzoli, 2013; Kuo et al., 2014).”
Method
Transcranial magnetic stimulation, transcranial direct current stimulation and electroconvulsive therapy for medication-resistant psychosis of schizophrenia
Nieuwdorp, W., Koops, S., Somers, M., & Sommer, I. E. (2015) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000156 · Cited by 26
“The advantage here is that the combined effects of this treatment method do not only target the positive symptom of AVH, but concurrently may ameliorate negative symptoms and cognitive functioning [14,15].”
Neural substrate and underlying mechanisms of working memory: insights from brain stimulation studies
Haque, Z. Z., Samandra, R., & Mansouri, F. A. (2021) · Journal of Neurophysiology · doi:10.1152/jn.00041.2021 · Cited by 26
Bacomics: a comprehensive cross area originating in the studies of various brain–apparatus conversations
Yao, D., Zhang, Y., Liu, T., Xu, P., Gong, D., Lu, J., Xia, Y., Luo, C., Guo, D., Dong, L., et al. (2020) · Cognitive Neurodynamics · doi:10.1007/s11571-020-09577-7 · Cited by 25
“…stimulation (TMS) (Hallett 2000; Pascual-Leone et al. 1996; Perera et al. 2016), transcranial direct-current stimulation (tDCS) (Fregni et al. 2005; Kuo et al. 2014; Nitsche et al. 2009), ultrasound stimulation (Wang et al. 2020), functional electrical stimulation (FES) (Biasiucci et al. 2018;…”
Method
Effects of anodal transcranial direct current stimulation on motor evoked potentials variability in humans
Bashir, S., Ahmad, S., Alatefi, M., Hamza, A., Sharaf, M., Fecteau, S., & Yoo, W. (2019) · Physiological Reports · doi:10.14814/phy2.14087 · Cited by 33
“…or disrupt cognitive functions and help in improving a range of neurological and psychiatric impairments (Kuo and Nitsche, 2012; Fl€oel, 2014; Kuo et al., 2014; Christians et al., 2016; Shin et al., 2015; Antonenko et al., 2016; Bikson et al., 2016). tDCS has been widely used to modulate…”
Method
Entrainment of Human Alpha Oscillations Selectively Enhances Visual Conjunction Search
Müller, N. G., Vellage, A., Heinze, H., & Zaehle, T. (2015) · PLoS ONE · doi:10.1371/journal.pone.0143533 · Cited by 29
“alleviating depressive symptoms, need to last longer [23].”
Background
Anodal transcranial direct current stimulation prevents methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced neurotoxicity by modulating autophagy in an in vivo mouse model of Parkinson’s disease
Lee, S.-B., Kim, H.-T., Yang, H. O., & Jang, W. (2018) · Scientific Reports · doi:10.1038/s41598-018-33515-7 · Cited by 25
Head models of healthy and depressed adults for simulating the electric fields of non-invasive electric brain stimulation
Boayue, N. M., Csifcsák, G., Puonti, O., Thielscher, A., & Mittner, M. (2018) · F1000Research · doi:10.12688/f1000research.15125.2 · Cited by 27
Electrical Stimulation over Bilateral Occipito-Temporal Regions Reduces N170 in the Right Hemisphere and the Composite Face Effect
Yang, L., Zhang, W., Shi, B., Yang, Z., Wei, Z., Gu, F., Zhang, J., Cui, G., Liu, Y., Zhou, Y., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0115772 · Cited by 24
“The clinical value of tDCS as a tool in cognitive rehabilitation has also been advocated [9, 11, 12].”
Method
Erratum to: Implantable neurotechnologies: bidirectional neural interfaces—applications and VLSI circuit implementations
Greenwald, E., Masters, M. R., & Thakor, N. V. (2016) · Medical & Biological Engineering & Computing · doi:10.1007/s11517-016-1452-6 · Cited by 23

Authors: Kuo, M.-F., Paulus, W., & Nitsche, M. A.
Affiliations: Universitätsmedizin Göttingen (DE)
Corresponding author: Nitsche, Michael A.
ORCID: Kuo, Min-Fang
Paulus, Walter
Nitsche, Michael A.
Venue: NeuroImage
Publisher: Elsevier BV
Published: 2014-01
Volume: 85
Pages: 948-960
ISSN: 1053-8119 (ISSN-L)
DOI: 10.1016/j.neuroimage.2013.05.117
OpenAlex: W2057070604
Cited by: 415
References: 149
Citations by year: 2026: 12 · 2025: 18 · 2024: 18 · 2023: 16 · 2022: 22 · 2021: 32 · 2020: 27 · 2019: 29 · 2018: 40 · 2017: 50 · 2016: 55 · 2015: 51 · 2014: 31
FWCI: 4.85
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: NeuroImage (publishedVersion)
PubMed (publishedVersion)
GRO (submittedVersion)
Funders: German Research Society (Ni 683/4-2, Ni 683/6-1)
German Ministry for Education and Research (03IPT605E)
Topics: Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
Keywords: transcranial direct current stimulation, non-invasive brain stimulation, neuroplasticity, neuropsychiatric disorders, stimulation optimization
MeSH terms: Mental Disorders, Electric Stimulation Therapy, Humans, Neuronal Plasticity, Tinnitus, Pain Management

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Therapeutic effects of non-invasive brain stimulation with direct currents (tDCS) in neuropsychiatric diseases

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