Clinical Research with Transcranial Direct Current Stimulation (tDCS): Challenges and Future Directions
By A. Brunoni, Michael A. Nitsche, N. Bolognini, Marom Bikson, Tim A. Wagner, Lotfi B. Merabet, Dylan J. Edwards, Antoni Valero-Cabré, A. Rotenberg, Alvaro Pascual-Leone and 4 more. Brain Stimulation, 2011
1,390 citations recorded by the source corpus.
Background Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity, direct current to cortical areas facilitating or inhibiting spontaneous neuronal activity. In the past ten years, tDCS physiological mechanisms of action have been intensively investigated giving support for the investigation of its applications in clinical neuropsychiatry and rehabilitation. However, new methodological, ethical, and regulatory issues emerge when translating the findings of preclinical and phase I studies into phase II and III clinical studies. The aim of this comprehensive review is to discuss the key challenges of this process and possible methods to address them. Methods We convened a workgroup of researchers in the field to review, discuss and provide updates and key challenges of neuromodulation use for clinical research. Main Findings/Discussion We reviewed several basic and clinical studies in the field and identified potential limitations, taking into account the particularities of the technique. We review and discuss the findings into four topics: (i) mechanisms of action of tDCS, parameters of use and computer-based human brain modeling investigating electric current fields and magnitude induced by tDCS; (ii) methodological aspects related to the clinical research of tDCS as divided according to study phase (i.e., preclinical, phase I, phase II and phase III studies); (iii) ethical and regulatory concerns; (iv) future directions regarding novel approaches, novel devices, and future studies involving tDCS. Finally, we propose some alternative methods to facilitate clinical research on tDCS.
Subfields: Anesthesiology and Pain Medicine, Neurology, Psychiatry and Mental health
View Paper: https://www.semanticscholar.org/paper/acf9e2fc4f0e78791aed0801bac4060efb4d57a9
How researchers see this paper
The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.
In Neurology
- Michael A. Nitsche
- Walter Paulus
- Leonardo G. Cohen
- Felipe Fregni
- C. J. Stagg
- Agnes Flöel
- David Liebetanz
- Andrea Antal
In Psychiatry and Mental health
Citations in the corpus
- A technical guide to tDCS, and related non-invasive brain stimulation tools (2015, background): “The primary outcomes are usually clinical (although surrogate biomarkers are evaluated as well; Brunoni et al., 2012)”
- Safety of transcranial Direct Current Stimulation: Evidence Based Update 2016 (2016, background): “Operator intentions when applying tDCS, the efficacy of tDCS in eliciting desired outcomes [3], and the presumed mechanisms of tDCS are not relevant for the scope of this review [4].”
- Neuroscience and Biobehavioral Reviews Auditory Verbal Hallucinations as Atypical Inner Speech Monitoring, and the Potential of Neurostimulation as a Treatment Option (neutral): “On top of this, tDCS is less expensive and easier to apply than rTMS, and can potentially be used by patients at their own homes, with the clinician providing indirect support with a remote trigger (Brunoni et al., 2012).”