Cognitive, Mood, and Electroencephalographic Effects of Noninvasive Cortical Stimulation With Weak Electrical Currents

Tadini, L.; El-Nazer, Rasheda; Brunoni, André R.; Williams, Julie; Carvas, Marcelo; Boggio, Paulo S.; Priori, Alberto; Pascual‐Leone, Álvaro; Fregni, Felipe

doi:10.1097/yct.0b013e3181e631a8

Cited by 61 publications

(51 citation statements)

References 41 publications

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“…Nitsche et al 2012;Peña-Gómez et al 2011;Plazier et al 2012;Vanderhasselt et al 2013), although Fregni et al (2008) completed the final evaluation approximately 10 min after stimulation cessation, while Tadini et al (2011) Batsikadze et al 2013). It is possible that the convention timing of re-assessment following tDCS does not allow for a sufficient period to detect tDCS-induced modulations of mood.…”

Section: Discussionmentioning

confidence: 99%

Acute and repetitive fronto-cerebellar tDCS stimulation improves mood in non-depressed participants

et al. 2017

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second-daily (n = 21). In a second experiment, we separately investigated the influence of reversed polarity upon these same measures, in response to acute stimulation (n = 23) and repeated stimulation (n = 11). We observed a systematic elevation of mood in both active conditions following single and repeated tDCS, the latter of which displayed a progressive elevation of mood from baseline. No mood change was noted in response to either single or repeated stimulation in the sham condition. Frontocerebellar tDCS stimulation advantageously influences mood in healthy participants, with an accumulative and potentiated effect following successive stimulations. The possibility that frontocerebellar stimulation may provide a novel therapeutic adjunctive or pre-emptive intervention in stress-related disorders and mood-related psychopathologies should be considered.

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Section: Discussionmentioning

confidence: 99%

Acute and repetitive fronto-cerebellar tDCS stimulation improves mood in non-depressed participants

et al. 2017

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“…Our observations here are similar to previous findings. There have been rare reports of mild electrical "shock" occurring with no injury during tES which is associated with abrupt making or breaking of the stimulating circuit [21,28,47].…”

Section: Withdrawal and Serious Adverse Eventsmentioning

confidence: 99%

“…Based on prior trials [21,28,47], we developed a comprehensive adverse-event monitoring plan, and implemented conservative (preventative) study withdrawal criterion. We typically could not distinguish between adverse effects and adverse event,…”

Section: General Observations and Compliancementioning

confidence: 99%

“…Based on the studies reported thus far, repeated use of tES on normal subjects and by healthy individuals is not expected to pose any significant risks as evidenced by : 1) repeated treatment sessions in clinical populations [19,20]; 2) acute studies applying a single or few treatment sessions in healthy subjects [9,[21][22][23][24][25][26][27][28]; and 3) absence of any established theoretical risk [29,30]. None-the-less, empirical observations on the safety and tolerability of repeated tES across an extended period by healthy volunteers would inform ongoing trials and future studies, as well as individuals interested in the use of tES for lifestyle and wellness applications including for modulation of psychophysiological arousal or cognitive and mood enhancement [31][32][33].…”

Section: Introductionmentioning

confidence: 99%

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The tolerability of transcranial electrical stimulation used across extended periods in a naturalistic context by healthy individuals

Paneri

Khadka

Patel

et al. 2015

Preprint

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Transcranial electrical stimulation (tES) is one of the most widely implemented forms of non-invasive neuromodulation in basic and clinical neuroscience. Further, the use of tES by healthy populations for various purposes is growing widespread daily. The effects of tES protocols on the skin and other tissues has remained uncharacterized when used across extended periods of time by healthy individuals. Therefore, we examined the basic safety and tolerability profile of two distinct tES protocols used repeatedly across an extended period of time by healthy subjects and report our findings here for the first time. The safety and tolerability profile previously accumulated regarding extended use of tES in clinical populations is compelling and supports a low-risk or non-significant risk designation. In the present study, we tested the tolerability (safety) and compliance, compared to sham, of two common tES approaches having a current density < 2 mA/cm 2 ; transcranial Direct Current Stimulation (tDCS) or transcranial Pulsed Current Stimulation (tPCS) used by healthy subjects three to five days (17 -20 minutes per day) per week for up to six weeks in a naturalistic environment. In this study 100 healthy subjects were randomized to one of three treatment groups: tDCS (n = 33), tPCS (n = 30), or sham (n = 37) and blinded to the treatment condition. The tES and sham waveforms were delivered through self-adhering electrodes on the right lateral forehead and back of the neck. We conducted 1905 treatment sessions (636 sham, 623 tDCS, and 646 tPCS sessions) on study volunteers over a six-week period. There were no serious adverse events in any treatment condition. Common side effects were primarily restricted to influences upon the skin and included skin tingling, itching, and mild burning sensations. The incidence of these events in active tES treatment arms (tPCS, tDCS) was equivalent or significantly lower than their incidence in the sham treatment arm. Other adverse events had a rarity (< 5% incidence) that could not be statistically distinguished across the treatment groups. Some subjects withdrew early from the study for atypical headache (sham n = 2, tDCS n = 2, and tPCS n = 3), atypical discomfort (sham n = 0, tDCS n = 1, and tPCS n = 1), or atypical skin irritation (sham n = 2, tDCS n = 8, and tPCS n = 1). The compliance (elected sessions completed) for tPCS was significantly greater when compared to sham (p = 0.007). The present study represents the most comprehensive analysis of tES tolerability and safety in healthy subjects to date. Limited to the hardware, electrodes, and protocols tested here, we conclude that repeated use of limited output tES across extended periods, is well tolerated and poses no significant risks to healthy subjects, as previously observed in clinical studies.

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“…In an animal study of safety, Liebetanz et al 14 showed, in an animal study of safety, that cathodal-induced brain lesions only occurred when the stimulation intensities almost one hundred times higher than used in clinical studies. In addition, tDCS does not adversely affect brain and heart activity, respectively measured using EEG and EKG records [15][16][17] . In fact, the only adverse effect particularly associated with tDCS is skin redness 18 -even though, this effect is mild and does not seem to compromise blinding in sham-controlled tDCS trials 19 , which consist in turning off the device after < 30-60 seconds of stimulation, remaining turned off until the end of the session 20 .…”

Section: Introductionmentioning

confidence: 99%

Novel neurotherapeutics in psychiatry: use and rationale of transcranial direct current stimulation in major depressive disorder

Moffa¹,

Valiengo²,

Shiozawa³

et al. 2014

Rev. psiquiatr. clín.

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Background: Transcranial direct current stimulation (tDCS) is a novel non-pharmacological intervention being investigated for the treatment of major depressive disorder (MDD). Objective: To perform an updated review of tDCS for MDD. Method: Systematic review in Medline/PubMed and other databases of all clinical studies evaluating the clinical efficacy of tDCS in MDD, from the first date available to December/2013. Results: Out of 55 articles, 24 were included, being 6 open-label studies; 8 randomized, double-blind, sham-controlled trials; 2 follow-up studies; 2 meta-analyses and 6 case reports. We observed an improvement of 20-40% in depressive symptoms, being slightly better in open studies. Five randomized clinical trials displayed positive results. The meta--analyses presented mixed results; although none included the study of that represents almost 50% of the evaluated sample. Open-label studies and case reports also investigated tDCS in bipolar depression, post-stroke depression and employed different parameters of stimulation. Discussion: TDCS is a novel, promising treatment for MDD. Definite evidence from large, ongoing clinical trials will be available in the next years.

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Cognitive, Mood, and Electroencephalographic Effects of Noninvasive Cortical Stimulation With Weak Electrical Currents

Cited by 61 publications

References 41 publications

Acute and repetitive fronto-cerebellar tDCS stimulation improves mood in non-depressed participants

Acute and repetitive fronto-cerebellar tDCS stimulation improves mood in non-depressed participants

The tolerability of transcranial electrical stimulation used across extended periods in a naturalistic context by healthy individuals

Novel neurotherapeutics in psychiatry: use and rationale of transcranial direct current stimulation in major depressive disorder

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