Low-Intensity Transcranial Current Stimulation in Psychiatry

Abstract

Neurostimulation is rapidly emerging as an important treatment modality for psychiatric disorders. One of the fastest-growing and least regulated approaches to noninvasive therapeutic stimulation involves the application of weak electrical currents. Widespread enthusiasm for low-intensity transcranial electrical current stimulation (tCS) is reflected by the recent surge in direct-to-consumer device marketing, do-it-yourself enthusiasm, and an escalating number of clinical trials. In the wake of this rapid growth, clinicians may lack sufficient information about tCS to inform their clinical practices. Interpretation of tCS clinical trial data is aided by familiarity with basic neurophysiological principles, potential mechanisms of action of tCS, and the complicated regulatory history governing tCS devices. A growing literature includes randomized controlled trials of tCS for major depression, schizophrenia, cognitive disorders and substance use disorders. The relative ease of use and abundant access to tCS may represent a broad-reaching and important advance for future mental health care. Evidence supports application of one type of tCS, transcranial direct current stimulation (tDCS), for major depression. However, tDCS devices do not have regulatory approval for treating medical disorders, evidence is largely inconclusive for other therapeutic areas, and their use is associated with some physical and psychiatric risks. One unexpected finding to arise from this review is that the use of cranial electrotherapy stimulation (CES) devices – the only category of tCS devices cleared for use in psychiatric disorders - is supported by low quality evidence.

Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines

“…Other problems are related to the diverse and multifaceted regulations in different countries and to the quality of performed trials. For example, recent findings even suggest that other electrical stimulation devices and methods that are cleared for use in psychiatric disorders are supported by low-quality data only (Philip et al, 2017). …”

Behavior Disorders: knowledge and actions of health professionals and social work

“…Another treatment modality evidenced as necessary for BP was transcranial electrostimulation, mentioned by one of the professionals of this study. However, the use of this procedure has robust evidence of improvement in the treatment of depressive disorders, and its use in other psychiatric disorders lacks evidence (20) .…”

Alternative Strategies for Managing Insomnia: The Case of Physical Exercise and Transcranial Direct Current Stimulation. A Narrative Review

“…tDCS has been used for multiple health purposes [48][49][50][51][52][53]. Regarding the use of tDCS in insomnia, the role of prefronto-thalamic-cerebellar circuit on cognitive dysfunctions and sleep quality in euthymic bipolar disorder (BD) patients have showed that tDCS (2 mA) for 20 min/day during 3 consecutive weeks applied to left dorsolateral prefrontal cortex (DLPFC) and right cerebellar cortex improved sleep [54].…”