Safety of transcranial Direct Current Stimulation: Evidence Based Update 2016
By Marom Bikson, Pnina Grossman, Chris Thomas, A. Zannou, Jimmy Jiang, Tatheer Adnan, Antonios P. Mourdoukoutas, G. Kronberg, D. Truong, P. Boggio and 19 more. Brain Stimulation, 2016
1,194 citations recorded by the source corpus.
This review updates and consolidates evidence on the safety of transcranial Direct Current Stimulation (tDCS). Safety is here operationally defined by, and limited to, the absence of evidence for a Serious Adverse Effect, the criteria for which are rigorously defined. This review adopts an evidence-based approach, based on an aggregation of experience from human trials, taking care not to confuse speculation on potential hazards or lack of data to refute such speculation with evidence for risk. Safety data from animal tests for tissue damage are reviewed with systematic consideration of translation to humans. Arbitrary safety considerations are avoided. Computational models are used to relate dose to brain exposure in humans and animals. We review relevant dose-response curves and dose metrics (e.g. current, duration, current density, charge, charge density) for meaningful safety standards. Special consideration is given to theoretically vulnerable populations including children and the elderly, subjects with mood disorders, epilepsy, stroke, implants, and home users. Evidence from relevant animal models indicates that brain injury by Direct Current Stimulation (DCS) occurs at predicted brain current densities (6.3–13 A/m2) that are over an order of magnitude above those produced by conventional tDCS. To date, the use of conventional tDCS protocols in human trials (≤40 min, ≤4 mA, ≤7.2 Coulombs) has not produced any reports of a Serious Adverse Effect or irreversible injury across over 33,200 sessions and 1,000 subjects with repeated sessions. This includes a wide variety of subjects, including persons from potentially vulnerable populations.
Subfields: Anesthesiology and Pain Medicine, Neurology, Psychiatry and Mental health
View Paper: https://www.semanticscholar.org/paper/05b064c7bfd7e0c0e76fea54f107e60126624a13
How researchers see this paper
The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.
In Anesthesiology and Pain Medicine
In Neurology
- Michael A. Nitsche
- Alvaro Pascual-Leone
- Agnes Flöel
- Leonardo G. Cohen
- Walter Paulus
- Felipe Fregni
- John C. Rothwell
- Friedhelm Christoph Hummel
In Psychiatry and Mental health
- Michael A. Nitsche
- Walter Paulus
- John C. Rothwell
- Hartwig Roman Siebner
- Christoph S. Herrmann
- Agnes Flöel
Citations in the corpus
- Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). (2017, background): “The safety profile of tDCS is very high, as far as explored, with regard to the currently applied protocols (Bikson et al., 2016).”
- Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines (2017, methodology): “2 coulombs of charge) (Bikson et al., 2016) to apply frequencies between 0 and 10,000 Hz.”