Adverse events of tDCS and tACS: A review

Matsumoto, Hideyuki; Ugawa, Yoshikazu

doi:10.1016/j.cnp.2016.12.003

Cited by 265 publications

(194 citation statements)

References 120 publications

(182 reference statements)

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“…The unwanted effects reported by participants in the present study are consistent with the typical side effects reported in the tDCS literature . That a small number of subjects report persistent burns is in line with several reports of Bskin lesions^in the tDCS literature that have occurred while tDCS is being administered by trained professionals in laboratory settings (Matsumoto and Ugawa 2017;Rodríguez et al 2014;Wang et al 2015). Thus, it should not necessarily be concluded that users had skin burns/lesions because they Bmisused^tDCS, as such burns/lesions have occurred in controlled laboratory settings.…”

Section: Discussionsupporting

confidence: 51%

Who Uses Direct-to-Consumer Brain Stimulation Products, and Why? A Study of Home Users of tDCS Devices

Wexler

2017

J Cogn Enhanc

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Despite the attention garnered by the home (or Bdo-it-yourself^) use of tDCS (transcranial direct current stimulation), little is known about the population of actual users. The present study aimed to provide a comprehensive examination of those who purchase tDCS devices: who they are, how they learn about tDCS, and why and how they stimulate. A link to an online survey was sent to those who had purchased a tDCS device from seven different companies selling tDCS devices to the public as of June 2016; data was analyzed from 339 participants, the majority of whom reported residing in North America. The typical respondent was a wealthy, highly educated, liberal, fortysomething male living in the USA who reported being an early adopter of technology. Nearly three quarters of respondents reported using tDCS for cognitive enhancement, one-quarter for restoration, and approximately 40% for treatment; many participants selected a combination of usage indications. Notably, approximately one third of participants utilize tDCS to self-treat depression. Most who use tDCS for treatment find the technology to be effective, whereas most who use it for non-treatment purposes (i.e., only enhancement and/or restoration) find it to be ineffective. Approximately 40% of those who purchase tDCS devices either quit using the device (mostly due to lack of efficacy) or have never used the device (mostly due to lack of guidance). Participants depart from established scientific protocol particularly with regard to frequency of stimulation, with 8.4% reporting self-administering 100+ sessions of tDCS. With regard to side effects, a small subset of users (n = 10) reported serious skin burns. This study provides an empirical foundation on which to base policy recommendations and offers a fact-based perspective on a bioethical debate that has too-often been one step removed from reality.

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Section: Discussionsupporting

confidence: 51%

Who Uses Direct-to-Consumer Brain Stimulation Products, and Why? A Study of Home Users of tDCS Devices

Wexler

2017

J Cogn Enhanc

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“…35 Adverse, rare effects include skin burns and mania or hypomania in patients with major depressive disorder. 36 tDCS has been used in a number of neuropsychiatric conditions including depression, 32 chronic pain, 17 cognitive enhancement, 37 and motor neurorehabilitation. 17,32 Various studies have been performed using tDCS for both episodic and chronic migraine, tension-type headache, and mixed headache.…”

Section: Introductionmentioning

confidence: 99%

Transcranial Magnetic and Direct Current Stimulation (TMS/tDCS) for the Treatment of Headache: A Systematic Review

et al. 2019

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Background Headache is among the most prevalent causes of disability worldwide. Non‐pharmacologic interventions, including neuromodulation therapies, have been proposed in patients who are treatment resistant or intolerant to medications. Objective To perform a systematic review on the use of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) for the treatment of specific headache disorders (ie, migraine, tension, cluster, posttraumatic). Methods Data sources: Ovid MEDLINE, Cochrane Central Register of Clinical Trials, Embase, Scopus, PsycINFO. Data extraction: All references were reviewed by 2 independent researchers (3039 abstracts, duplicates removed). Records were selected by inclusion criteria for participants (adults 18‐65 with primary or secondary headaches), interventions (TMS and tDCS applied as headache treatment), comparators (sham or alternative standard of care), and study type (cohort, case‐control, and randomized controlled trials [RCT]). Studies were assessed using the Cochrane Risk of Bias Tool and overall quality determined through the GRADE Tool. A structured synthesis was performed due to heterogeneity of participants and methods. Results Thirty‐four studies were included: 16 rTMS, 6 TMS (excluding rTMS), and 12 tDCS. The majority investigated treatment for migraine (19/22 TMS, 8/12 tDCS). Quality of evidence ranged from very low to high. Conclusion Of all TMS and tDCS modalities, rTMS is most promising with moderate evidence that it contributes to reductions in headache frequency, duration, intensity, abortive medication use, depression, and functional impairment. However, only few studies reported changes greater than sham treatment. Further high‐quality RCTs with standardized protocols are required for each specific headache disorder to validate a treatment effect. Registration Number: PROSPERO 2017 CRD42017076232.

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“…tDCS is assumed to modulate cortical excitability depending on the polarity of the stimulation and is used to study cognitive functions in humans (Santarnecchi et al, 2015). At low intensities, tDCS induces a moderate amount of perceptual adverse effects that include cutaneous discomfort such as itching, tingling, burning or piercing sensations (Fertonani, Ferrari, & Miniussi, 2015;Matsumoto & Ugawa, 2017;Poreisz, Boros, Antal, & Paulus, 2007).…”

Section: Introductionmentioning

confidence: 99%

Blinding is compromised for transcranial direct current stimulation at 1 mA for 20 min in young healthy adults

Turi

Csifcsák

Boayue

et al. 2019

Eur J of Neuroscience

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Transcranial direct current stimulation (tDCS) is a non‐invasive brain stimulation method that is frequently used to study cortical excitability changes and their impact on cognitive functions in humans. While most stimulators are capable of operating in double‐blind mode, the amount of discomfort experienced during tDCS may break blinding. Therefore, specifically designed sham stimulation protocols are being used. The “fade‐in, short‐stimulation, fade‐out” (FSF) protocol has been used in hundreds of studies and is commonly believed to be indistinguishable from real stimulation applied at 1 mA for 20 min. We analysed subjective reports of 192 volunteers, who either received real tDCS (n = 96) or FSF tDCS (n = 96). Participants reported more discomfort for real tDCS and correctly guessed the condition above chance‐level. These findings indicate that FSF does not ensure complete blinding and that better active sham protocols are needed.

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Adverse events of tDCS and tACS: A review

Abstract: HighlightsNo serious adverse effects have been reported in experiments using either tDCS or tACS.Persistent adverse effects of tDCS are mainly skin problems; for tACS, none have been reported.Further safety investigations are needed.

Cited by 265 publications

References 120 publications

Who Uses Direct-to-Consumer Brain Stimulation Products, and Why? A Study of Home Users of tDCS Devices

Who Uses Direct-to-Consumer Brain Stimulation Products, and Why? A Study of Home Users of tDCS Devices

Transcranial Magnetic and Direct Current Stimulation (TMS/tDCS) for the Treatment of Headache: A Systematic Review

Blinding is compromised for transcranial direct current stimulation at 1 mA for 20 min in young healthy adults

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