Charge density, not current density, is a more comprehensive safety measure of transcranial direct current stimulation

Chhatbar, Pratik Y.; George, Mark S.; Kautz, Steven A.; Feng, Wuwei

doi:10.1016/j.bbi.2017.08.008

Cited by 11 publications

(10 citation statements)

References 4 publications

(8 reference statements)

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Section: To the Editormentioning

confidence: 79%

“…It has been chosen to be consistent with our previous findings in mice [5] and other studies performed in rats [9]. Moreover, these parameters fall within the safety range suggested by similar stimulation condition in animal models [9]. Of note, in addition to the different current density, it has to be taken into account a different electric field direction and magnitude between mice and humans, due to their vast anatomical differences.…”

Section: To the Editormentioning

confidence: 91%

See 1 more Smart Citation

Transcranial direct current stimulation of the mouse prefrontal cortex modulates serotonergic neural activity of the dorsal raphe nucleus

Cambiaghi¹,

Buffelli²,

Masin

et al. 2020

Brain Stimulation

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Section: To the Editormentioning

confidence: 79%

Section: To the Editormentioning

confidence: 91%

Transcranial direct current stimulation of the mouse prefrontal cortex modulates serotonergic neural activity of the dorsal raphe nucleus

Cambiaghi¹,

Buffelli²,

Masin

et al. 2020

Brain Stimulation

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“…Charge density is a more comprehensive safety measure than current density for tDCS because the parameter of charge density takes into consideration of stimulation duration. 23,24 Simulations on spherical head models 14 (with skull and scalp layers intactness assumption) suggest that current in the order of 10 mA likely leads to the generation of electric fields that are comparable to those generated in rodent brain without any apparent brain damage (Fig. 2).…”

Section: Optimal Dose and Safety Concernsmentioning

confidence: 99%

Transcranial Direct Current Stimulation for Poststroke Motor Recovery: Challenges and Opportunities

Feng

Kautz

Schlaug

et al. 2018

PM&R

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There has been a renewed research interest in transcranial direct current stimulation (tDCS) as an adjunctive tool for poststroke motor recovery as it has a neuro‐modulatory effect on the human cortex. However, there are barriers towards its successful application in motor recovery as several scientific issues remain unresolved, including device‐related issues (ie, dose‐response relationship, safety and tolerability concerns, interhemispheric imbalance model, and choice of montage) and clinical trial‐related issues (ie, patient selection, timing of study, and choice of outcomes). This narrative review examines and discusses the existing challenges in using tDCS as a brain modulation tool in facilitating recovery after stroke. Potential solutions pertinent to using tDCS with the goal of harnessing the brains plasticity are proposed.

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“…We chose an intensity of 1 mA because higher intensities tend to provoke more paresthesias and could lead to unblinding [3]. We chose a total of 6 sessions with alternate days, in line with the average numbers of sessions (5)(6)(7)(8)(9)(10) reported in the literature [12,[14][15][16][17]. TDCS was delivered before physical therapy, as performed by other studies that intended to prime cortical excitability prior to motor training [12,14,34].…”

Section: Interventionmentioning

confidence: 99%

“…Hand paresis affects up to 80% of the subjects in the acute phase after ischemic stroke and substantially contributes to disability [1,2]. Over the past several decades, transcranial direct current stimulation (tDCS) has emerged as a potential tool to enhance upper limb motor recovery [3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Contralesional Cathodal Transcranial Direct Current Stimulation Does Not Enhance Upper Limb Function in Subacute Stroke: A Pilot Randomized Clinical Trial

et al. 2021

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Transcranial direct current stimulation (tDCS) has the potential to improve upper limb motor outcomes after stroke. According to the assumption of interhemispheric inhibition, excessive inhibition from the motor cortex of the unaffected hemisphere to the motor cortex of the affected hemisphere may worsen upper limb motor recovery after stroke. We evaluated the effects of active cathodal tDCS of the primary motor cortex of the unaffected hemisphere (ctDCSM1UH) compared to sham, in subjects within 72 hours to 6 weeks post ischemic stroke. Cathodal tDCS was intended to inhibit the motor cortex of the unaffected hemisphere and hence decrease the inhibition from the unaffected to the affected hemisphere and enhance motor recovery. We hypothesized that motor recovery would be greater in the active than in the sham group. In addition, greater motor recovery in the active group might be associated with bigger improvements in measures in activity and participation in the active than in the sham group. We also explored, for the first time, changes in cognition and sleep after ctDCSM1UH. Thirty subjects were randomized to six sessions of either active or sham ctDCSM1UH as add-on interventions to rehabilitation. The NIH Stroke Scale (NIHSS), Fugl-Meyer Assessment of Motor Recovery after Stroke (FMA), Barthel Index (BI), Stroke Impact Scale (SIS), and Montreal Cognitive Assessment (MoCA) were assessed before, after treatment, and three months later. In the intent-to-treat (ITT) analysis, there were significant GROUP*TIME interactions reflecting stronger gains in the sham group for scores in NIHSS, FMA, BI, MoCA, and four SIS domains. At three months post intervention, the sham group improved significantly compared to posttreatment in FMA, NIHSS, BI, and three SIS domains while no significant changes occurred in the active group. Also at three months, NIHSS improved significantly in the sham group and worsened significantly in the active group. FMA scores at baseline were higher in the active than in the sham group. After adjustment of analysis according to baseline scores, the between-group differences in FMA changes were no longer statistically significant. Finally, none of the between-group differences in changes in outcomes after treatment were considered clinically relevant. In conclusion, active CtDCSM1UH did not have beneficial effects, compared to sham. These results were consistent with other studies that applied comparable tDCS intensities/current densities or treated subjects with severe upper limb motor impairments during the first weeks post stroke. Dose-finding studies early after stroke are necessary before planning larger clinical trials.

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Charge density, not current density, is a more comprehensive safety measure of transcranial direct current stimulation

Cited by 11 publications

References 4 publications

Transcranial direct current stimulation of the mouse prefrontal cortex modulates serotonergic neural activity of the dorsal raphe nucleus

Transcranial direct current stimulation of the mouse prefrontal cortex modulates serotonergic neural activity of the dorsal raphe nucleus

Transcranial Direct Current Stimulation for Poststroke Motor Recovery: Challenges and Opportunities

Contralesional Cathodal Transcranial Direct Current Stimulation Does Not Enhance Upper Limb Function in Subacute Stroke: A Pilot Randomized Clinical Trial

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