Ten minutes of 1mA transcranial direct current stimulation was well tolerated by children and adolescents: Self-reports and resting state EEG analysis

Moliadze, Vera; Andreas, Saskia; Lyzhko, Ekaterina; Schmanke, Till; Gurashvili, Tea; Freitag, Christine M.; Siniatchkin, Michael

doi:10.1016/j.brainresbull.2015.09.011

Cited by 37 publications

(25 citation statements)

References 36 publications

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“…to enhance rehabilitation results in children suffering from cerebral palsy. Similar results with regard to safety and tolerability of tDCS in healthy pediatric populations have been reported by another study in which anodal, cathodal, and sham tDCS (1 mA for 10 min) was applied over the left primary motor cortex of children and adolescents (aged 11-16 years) (Moliadze et al, 2015b). Also in this study, the protocol was well tolerated, as monitored by self-reports of the participants, and no serious adverse events were reported after real or sham stimulation.…”

Section: Healthy Childrensupporting

confidence: 85%

Applications of transcranial direct current stimulation in children and pediatrics

Rivera-Urbina¹,

Nitsche

Vicario

et al. 2016

Reviews in the Neurosciences

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AbstractTranscranial direct current stimulation (tDCS) is a neuromodulatory noninvasive brain stimulation tool with potential to increase or reduce regional and remote cortical excitability. Numerous studies have shown the ability of this technique to induce neuroplasticity and to modulate cognition and behavior in adults. Clinical studies have also demonstrated the ability of tDCS to induce therapeutic effects in several central nervous system disorders. However, knowledge about its ability to modulate brain functions in children or induce clinical improvements in pediatrics is limited. The objective of this review is to describe relevant data of some recent studies that may help to understand the potential of this technique in children with specific regard to effective and safe treatment of different developmental disorders in pediatrics. Overall, the results show that standard protocols of tDCS are well tolerated by children and have promising clinical effects. Nevertheless, treatment effects seem to be partially heterogeneous, and a case of a seizure in a child with previous history of infantile spasms and diagnosed epilepsy treated with tDCS for spasticity was reported. Further research is needed to determine safety criteria for tDCS use in children and to elucidate the particular neurophysiological changes induced by this neuromodulatory technique when it is applied in the developing brain.

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Section: Healthy Childrensupporting

confidence: 85%

Applications of transcranial direct current stimulation in children and pediatrics

Rivera-Urbina¹,

Nitsche

Vicario

et al. 2016

Reviews in the Neurosciences

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“…A randomized, controlled, crossover study of the AEs of tDCS in healthy children and adolescents (mean age 13.9, range 11–16 yrs) showed that tDCS with 1 mA intensity over 10 min is well tolerated in children and adolescents. No pathological oscilla tions, and in particular, no markers of epileptiform activity, after 1 mA tDCS were detected in any of the EEG analyses (Moliadze et al, 2015a). Long-term EEG monitoring was not performed (Bogdanov et al, 1994; Moliadze et al, 2015a).…”

Section: The Application Of Low Intensity Tes In Human Studies: Aementioning

confidence: 99%

“…No pathological oscilla tions, and in particular, no markers of epileptiform activity, after 1 mA tDCS were detected in any of the EEG analyses (Moliadze et al, 2015a). Long-term EEG monitoring was not performed (Bogdanov et al, 1994; Moliadze et al, 2015a). …”

Section: The Application Of Low Intensity Tes In Human Studies: Aementioning

confidence: 99%

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

Antal

Alekseichuk

Bikson

et al. 2017

Clinical Neurophysiology

933

728

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Low intensity transcranial electrical stimulation (TES) in humans, encompassing transcranial direct current (tDCS), transcutaneous spinal Direct Current Stimulation (tsDCS), transcranial alternating current (tACS), and transcranial random noise (tRNS) stimulation or their combinations, appears to be safe. No serious adverse events (SAEs) have been reported so far in over 18,000 sessions administered to healthy subjects, neurological and psychiatric patients, as summarized here. Moderate adverse events (AEs), as defined by the necessity to intervene, are rare, and include skin burns with tDCS due to suboptimal electrode-skin contact. Very rarely mania or hypomania was induced in patients with depression (11 documented cases), yet a causal relationship is difficult to prove because of the low incidence rate and limited numbers of subjects in controlled trials. Mild AEs (MAEs) include headache and fatigue following stimulation as well as prickling and burning sensations occurring during tDCS at peak-to-baseline intensities of 1–2 mA and during tACS at higher peak-to-peak intensities above 2 mA. The prevalence of published AEs is different in studies specifically assessing AEs vs. those not assessing them, being higher in the former. AEs are frequently reported by individuals receiving placebo stimulation. The profile of AEs in terms of frequency, magnitude and type is comparable in healthy and clinical populations, and this is also the case for more vulnerable populations, such as children, elderly persons, or pregnant women. Combined interventions (e.g., co-application of drugs, electrophysiological measurements, neuroimaging) were not associated with further safety issues. Safety is established for low-intensity ‘conventional’ TES defined as <4 mA, up to 60 min duration per day. Animal studies and modeling evidence indicate that brain injury could occur at predicted current densities in the brain of 6.3–13 A/m2 that are over an order of magnitude above those produced by tDCS in humans. Using AC stimulation fewer AEs were reported compared to DC. In specific paradigms with amplitudes of up to 10 mA, frequencies in the kHz range appear to be safe. In this paper we provide structured interviews and recommend their use in future controlled studies, in particular when trying to extend the parameters applied. We also discuss recent regulatory issues, reporting practices and ethical issues. These recommendations achieved consensus in a meeting, which took place in Göttingen, Germany, on September 6–7, 2016 and were refined thereafter by email correspondence.

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“…Indeed, in a rat seizure model, Liebetanz et al (2006) reported that seizure threshold was not reduced by anodal tDCS (Liebetanz et al, 2006). tDCS within the standard protocols is considered safe for both adults and children and for both healthy subjects and patients (Nitsche and Paulus, 2001, Nitsche and Paulus, 2015, Nitsche et al, 2003a, Nitsche et al, 2003b, Arul-Anandam et al, 2009, Borckardt et al, 2011, Borckardt et al, 2012, Peruzzotti-Jametti et al, 2013, Bennabi et al, 2015, Gillick et al, 2015, Ho et al, 2015, Krishnan et al, 2015, Matsumoto and Ugawa, 2015, Meron et al, 2015, Moliadze et al, 2015, Oberman and Enticott, 2015, San-Juan et al, 2015, Smit et al, 2015, Xu et al, 2015, Aparício et al, 2016, Arumugham et al, 2016, Bikson et al, 2016, Cha et al, 2016, Gbadeyan et al, 2016, Hu et al, 2016, Muszkat et al, 2016, Palm et al, 2016, Rubio et al, 2016, Shivakumar et al, 2016, Woods et al, 2016). Yet it remains important to be aware of the potential adverse effects of tDCS.…”

Section: Introductionmentioning

confidence: 99%

Adverse events of tDCS and tACS: A review

Matsumoto

Ugawa

2017

Clinical Neurophysiology Practice

264

160

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Ten minutes of 1mA transcranial direct current stimulation was well tolerated by children and adolescents: Self-reports and resting state EEG analysis

Cited by 37 publications

References 36 publications

Applications of transcranial direct current stimulation in children and pediatrics

Applications of transcranial direct current stimulation in children and pediatrics

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

Adverse events of tDCS and tACS: A review

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