Updated Technique for Reliable, Easy, and Tolerated Transcranial Electrical Stimulation Including Transcranial Direct Current Stimulation

Abstract

Transcranial direct current stimulation (tDCS) is a noninvasive method of neuromodulation using low-intensity direct electrical currents. This method of brain stimulation presents several potential advantages compared to other techniques, as it is noninvasive, cost-effective, broadly deployable, and well-tolerated provided proper equipment and protocols are administered. Even though tDCS is apparently simple to perform, correct administration of the tDCS session, especially the electrode positioning and preparation, is vital for ensuring reproducibility and tolerability. The electrode positioning and preparation steps are traditionally also the most time consuming and error-prone. To address these challenges, modern tDCS techniques, using fixed-position headgear and pre-assembled sponge electrodes, reduce complexity and setup time while also ensuring that the electrodes are consistently placed as intended. These modern tDCS methods present advantages for research, clinic, and remote-supervised (at home) settings. This article provides a comprehensive step-by-step guide for administering a tDCS session using fixed-position headgear and pre-assembled sponge electrodes. This guide demonstrates tDCS using commonly applied montages intended for motor cortex and dorsolateral prefrontal cortex (DLPFC) stimulation. As described, selection of the head size and montage-specific headgear automates electrode positioning. Fully assembled pre-saturated snap-electrodes are simply affixed to the set position snap-connectors on the headgear. The modern tDCS method is shown to reduce setup time and reduce errors for both novice and expert operators. The methods outlined in this article can be adapted to different applications of tDCS as well as other forms of transcranial electrical stimulation (tES) such as transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNS). However, since tES is application specific, as appropriate, any methods recipe is customized to accommodate subject, indication, environment, and outcome specific features.

Functional Kinesiology in Health and Performance

“…In addition, it may also relate to neurotransmitter variation caused by current changes, effects of glial cells and microvessels, and inflammatory process regulation (Woods et al, 2016). However, the effects of tDCS depend on current intensity, polarity, relative position of electrode and intervention duration (Paulus, 2011;Angius et al, 2019a;Borges et al, 2020). Marom et al (Bikson et al, 2016) have summarized more than 33,200 courses of treatment and 1,000 repeated courses of treatment on human subjects and discovered no reports of serious adverse effects or irreversible injuries.…”

Effects of single session transcranial direct current stimulation on aerobic performance and one arm pull-down explosive force of professional rock climbers

“…In addition, it may also relate to neurotransmitter variation caused by current changes, effects of glial cells and microvessels, and inflammatory process regulation (Woods et al, 2016). However, the effects of tDCS depend on current intensity, polarity, relative position of electrode and intervention duration (Paulus, 2011;Angius et al, 2019a;Borges et al, 2020). Marom et al (Bikson et al, 2016) have summarized more than 33,200 courses of treatment and 1,000 repeated courses of treatment on human subjects and discovered no reports of serious adverse effects or irreversible injuries.…”