Despite the attention garnered by the home (or “do-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.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Antal, A., Alekseichuk, I., Bikson, M., Brockmöller, J., Brunoni, A. R., Chen, R., et al. (2017). Low intensity transcranial electric stimulation: safety, ethical, legal regulatory and application guidelines. Clinical Neurophysiology, 128(9), 1774–1809.
Batuman, E. (2015). Adventures in transcranial direct-current stimulation. Retrieved October 3, 2017, from http://www.newyorker.com/magazine/2015/04/06/electrified
Boshara, R., Emmons, W. R., & Noeth, B. J. (2015). The Demographics of wealth: how age, education and race separate thrivers from strugglers in today's economy. Essay No. 2: The Role of Education. Center for Household Financial Stability, Federal Reserve Bank of St. Louis.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa.
Brem, A.-K., Fried, P. J., Horvath, J. C., Robertson, E. M., & Pascual-Leone, A. (2014). Is neuroenhancement by noninvasive brain stimulation a net zero-sum proposition? NeuroImage, 85(Pt 3), 1058–1068. https://doi.org/10.1016/j.neuroimage.2013.07.038.
Brenninkmeijer, J., & Zwart, H. (2016). From ‘hard’ neuro-tools to ‘soft’ neuro-toys? Refocussing the neuro-enhancement debate. Neuroethics, 10(3), 337–348. https://doi.org/10.1007/s12152-016-9283-6.
Cabrera, L. Y., Evans, E. L., & Hamilton, R. H. (2013). Ethics of the electrified mind: defining issues and perspectives on the principled use of brain stimulation in medical research and clinical care. Brain Topography, 27(1), 33–45. https://doi.org/10.1007/s10548-013-0296-8.
Chi, M. T. H. (1997). Quantifying qualitative analyses of verbal data: a practical guide. Journal of the Learning Sciences, 6(3), 271–315. https://doi.org/10.1207/s15327809jls0603_1.
Denejkina, A. (2016) The promise and peril of DIY electrical brain stimulation. Retrieved October 27, 2017, from http://kernelmag.dailydot.com/issue-sections/headline-story/16371/diy-electrical-brain-stimulation-tdcs-promise-and-peril/
Dubljević, V., Saigle, V., & Racine, E. (2014). The rising tide of tDCS in the media and academic literature. Neuron, 82(4), 731–736. https://doi.org/10.1016/j.neuron.2014.05.003.
Eickenhorst, P., Vitzthum, K., Klapp, B. F., Groneberg, D., & Mache, S. (2012). Neuroenhancement among German university students: motives, expectations, and relationship with psychoactive lifestyle drugs. Journal of Psychoactive Drugs, 44(5), 418–427. https://doi.org/10.1080/02791072.2012.736845.
Farah, M. J. (2015). The unknowns of cognitive enhancement. Science, 350(6259), 379–380. https://doi.org/10.1126/science.aad5893.
Farah, M. J., Illes, J., Cook-Deegan, R., Gardner, H., Kandel, E., King, P., et al. (2004). Neurocognitive enhancement: what can we do and what should we do? Nature Reviews Neuroscience, 5(5), 421–425. https://doi.org/10.1038/nrn1390.
Fitz, N. S., & Reiner, P. B. (2014). The perils of using electrical stimulation to change human brains. In R. Cohen Kadosh (Ed.), The stimulated brain: cognitive enhancement using non-invasive brain stimulation (pp. 61–83). Elsevier. https://doi.org/10.1016/b978-0-12-404704-4.00003-x.
Fitz, N. S., & Reiner, P. B. (2015). The challenge of crafting policy for do-it-yourself brain stimulation. Journal of Medical Ethics, 41(5), 410–412. https://doi.org/10.1136/medethics-2013-101458.
Forlini, C., & Racine, E. (2009). Disagreements with implications: diverging discourses on the ethics of non-medical use of methylphenidate for performance enhancement. BMC Medical Ethics, 10(1), 421–413. https://doi.org/10.1186/1472-6939-10-9.
Forlini, C., Schildmann, J., Roser, P., Beranek, R., & Vollmann, J. (2014). Knowledge, experiences and views of German university students toward neuroenhancement: an empirical-ethical analysis. Neuroethics, 8(2), 83–92. https://doi.org/10.1007/s12152-014-9218-z.
Fregni, F., Nitsche, M. A., Loo, C. K., Brunoni, A. R., Marangolo, P., Leite, J., et al. (2015). Regulatory considerations for the clinical and research use of transcranial direct current stimulation (tDCS): review and recommendations from an expert panel. Clinical Research and Regulatory Affairs, 32(1), 22–35. https://doi.org/10.3109/10601333.2015.980944.
Hildt, E. (2014). On the current neuroenhancement use of transcranial direct current stimulation by healthy individuals—a non-fictional snap-shot: Commentary on Lapenta et al. 2014. Psychology & Neuroscience, 7(2), 181–182. https://doi.org/10.3922/j.psns.2014.011.
Horvath, J. C., Forte, J. D., & Carter, O. (2015). Quantitative review finds no evidence of cognitive effects in healthy populations from single-session transcranial direct current stimulation (tDCS). Brain Stimulation, 8(3), 535–550. https://doi.org/10.1016/j.brs.2015.01.400.
IFCN (International Federation of Clinical Neurophysiology (2015). Transcranial electric stimulation in do-it-yourself applications (pp. 1–3); http://www.ifcn.info/uploadfiles/documents/2015/Using_tES_devices_as_DIY_FINAL_13Dec15.pdf
Iuculano, T., & Cohen Kadosh, R. (2013). The mental cost of cognitive enhancement. Journal of Neuroscience, 33(10), 4482–4486. https://doi.org/10.1523/jneurosci.4927-12.2013.
Jwa, A. (2015). Early adopters of the magical thinking cap: a study on do-it-yourself (DIY) transcranial direct current stimulation (tDCS) user community. Journal of Law and the Biosciences, 2(2), 292–335. https://doi.org/10.1093/jlb/lsv017.
Lapenta, O. M., Valasek, C. A., Brunoni, A. R., & Boggio, P. S. (2014). An ethical discussion of the use of transcranial direct current stimulation for cognitive enhancement in healthy individuals: a fictional case study. Psychology & Neuroscience, 7(2), 175–180. https://doi.org/10.3922/j.psns.2014.010.
Lefaucheur, J.-P., Antal, A., Ayache, S. S., Benninger, D. H., Brunelin, J., Cogiamanian, F., et al. (2017). Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). Clinical Neurophysiology, 128(1), 56–92. https://doi.org/10.1016/j.clinph.2016.10.087.
Lombard, M., Snyder-Duch, J., & Bracken, C. C. (2002). Content analysis in mass communication: assessment and reporting of intercoder reliability. Human Communication Research, 28(4), 587–604. https://doi.org/10.1111/j.1468-2958.2002.tb00826.x.
Lucke, J. C., Bell, S., Partridge, B., & Hall, W. D. (2011). Deflating the neuroenhancement bubble. AJOB Neuroscience, 2(4), 38–43. https://doi.org/10.1080/21507740.2011.611122.
Mancuso, L. E., Ilieva, I. P., Hamilton, R. H., & Farah, M. J. (2016). Does transcranial direct current stimulation improve healthy working memory? A meta-analytic review. Journal of Cognitive Neuroscience, 28(8), 1063–1089. https://doi.org/10.1162/jocn_a_00956.
Maslen, H., Earp, B. D., Cohen Kadosh, R., & Savulescu, J. (2014). Brain stimulation for treatment and enhancement in children: an ethical analysis. Frontiers in Human Neuroscience, 8, 202–205. https://doi.org/10.3389/fnhum.2014.00953.
Matsumoto, H., & Ugawa, Y. (2017). Adverse events of tDCS and tACS: a review. Clinical Neurophysiology Practice, 2, 19–25. https://doi.org/10.1016/j.cnp.2016.12.003.
Miller, G. (2014). Inside the Strange New World of DIY Brain Stimulation. Retrieved October 3, 2017, from http://www.wired.com/2014/05/diy-brain-stimulation
Ott, R., & Biller-Andorno, N. (2014). Neuroenhancement among Swiss students—a comparison of users and non-users. Pharmacopsychiatry, 47(01), 22–28. https://doi.org/10.1055/s-0033-1358682.
Outram, S. M. (2010). The use of methylphenidate among students: the future of enhancement? Journal of Medical Ethics, 36(4), 198–202. https://doi.org/10.1136/jme.2009.034421.
Parens, E. (2014). Shaping ourselves: on technology, flourishing, and a habit of thinking. Oxford: Oxford University Press.
Partridge, B. J., Bell, S. K., Lucke, J. C., Yeates, S., & Hall, W. D. (2011). Smart drugs “as common as coffee”: media hype about neuroenhancement. PLoS One, 6(11), e28416. https://doi.org/10.1371/journal.pone.0028416.
Pew Research Center. (2015a). Public and scientists' views on Science and Society. http://assets.pewresearch.org/wp-content/uploads/sites/14/2015/01/PI_ScienceandSociety_Report_012915.pdf
Pew Research Center. (2015b). U.S. Public Becoming Less Religious. http://assets.pewresearch.org/wp-content/uploads/sites/11/2015/11/201.11.03_RLS_II_full_report.pdf
Pew Research Center. (2016a). Early Technology Adopters: Methodology. http://assets.pewresearch.org/wp-content/uploads/sites/12/2016/07/FT_2016_0711_TechAdopters_MethodologyTopline.pdf
Pew Research Center. (2016b). U.S. Public Wary of Biomedical Technologies to “Enhance” Human Abilities. http://www.pewinternet.org/2016/07/26/u-s-public-wary-of-biomedical-technologies-to-enhance-human-abilities/
Pew Research Center. (2016c). 2016 Party Identification Detailed Tables; Table 1. http://www.people-press.org/2016/09/13/2016-party-identification-detailed-tables/
Pew Research Center. (2016d). The Generations Defined. http://www.pewresearch.org/fact-tank/2016/08/29/this-may-be-the-last-presidential-election-dominated-by-boomers-and-prior-generations/ft_16-08-26_generationsdefined_2016_silentgreatest/
Radiolab. (2014). 9-Volt Nirvana. Retrieved October 3, 2017, from http://www.radiolab.org/story/9-volt-nirvana
Ragan, C. I., Bard, I., & Singh, I. (2013). What should we do about student use of cognitive enhancers? An analysis of current evidence. Neuropharmacology, 64(C), 588–595. https://doi.org/10.1016/j.neuropharm.2012.06.016.
Riddell, C., Jensen, C., & Carter, O. (2017). Cognitive enhancement and coping in an Australian university student sample, 1–7. https://doi.org/10.1007/s41465-017-0046-z.
Rodríguez, N., Opisso, E., Pascual-Leone, A., & Soler, M. D. (2014). Skin lesions induced by transcranial direct current stimulation (tDCS). Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation, 7(5), 765–767. https://doi.org/10.1016/j.brs.2014.06.005.
Saad, L. (2015). U.S. Liberals at Record 24%, but Still Trail Conservatives. Gallup Poll. http://www.gallup.com/poll/180452/liberals-record-trail-conservatives.aspx
Sarkar, A., Dowker, A., & Cohen Kadosh, R. (2014). Cognitive enhancement or cognitive cost: trait-specific outcomes of brain stimulation in the case of mathematics anxiety. The Journal of Neuroscience, 34(50), 16605–16610. https://doi.org/10.1523/jneurosci.3129-14.2014.
Steenbergen, L., Sellaro, R., Hommel, B., Lindenberger, U., Kühn, S., & Colzato, L. S. (2016). “Unfocus” on foc. us: commercial tDCS headset impairs working memory. Experimental Brain Research, 234(3), 637–643.
U.S. Census Bureau (2016). Household Income in 2015, All Races (Current Population Survey, 2016 Annual Social and Economic Supplement). https://www.census.gov/data/tables/time-series/demo/income-poverty/cps-hinc/hinc-01.html
U.S. Census Bureau (2017). Educational Attainment in the United States: 2015. https://www.census.gov/data/tables/2016/demo/education-attainment/cps-detailed-tables.html; Table 3.
Vargo, E. J., & Petróczi, A. (2016). “It was me on a good day”: exploring the smart drug use phenomenon in England. Frontiers in Psychology, 7(e14322), 779. https://doi.org/10.3389/fpsyg.2016.00779.
Voarino, N., Dubljević, V., & Racine, E. (2017). tDCS for memory enhancement: analysis of the speculative aspects of ethical issues. Frontiers in Human Neuroscience, 10, 271–213. https://doi.org/10.3389/fnhum.2016.00678.
Wang, J., Wei, Y., Wen, J., & Li, X. (2015). Skin burn after single session of transcranial direct current stimulation (tDCS). Brain Stimulation, 8(1), 165–166. https://doi.org/10.1016/j.brs.2014.10.015.
Wexler, A. (2016a). A pragmatic analysis of the regulation of consumer transcranial direct current stimulation (tDCS) devices in the United States. Journal of Law and the Biosciences, 2(3), 669–696. https://doi.org/10.1093/jlb/lsv039.
Wexler, A. (2016b). The practices of do-it-yourself brain stimulation: implications for ethical considerations and regulatory proposals. Journal of Medical Ethics, 42(4), 211–215. https://doi.org/10.1136/medethics-2015-102704.
Wexler, A. (2017). The social context of “do-it-yourself” brain stimulation: neurohackers, biohackers, and lifehackers. Frontiers in Human Neuroscience, 11, 331. https://doi.org/10.3389/fnhum.2017.00224.
Wexler, A., & Reiner, P. B. (2017). Home use of tDCS: from “do-it-yourself” to “direct-to-consumer.” In L. S. M. Johnson & K. S. Rommelfanger (Eds.), Routledge Handbook of Neuroethics (pp. 271–284).
Wurzman, R., Hamilton, R. H., Pascual-Leone, A., & Fox, M. D. (2016). An open letter concerning do-it-yourself users of transcranial direct current stimulation. Annals of Neurology, 80(1), 1–4. https://doi.org/10.1002/ana.24689.
The author thanks Nicholas S. Fitz for assistance with the design and coding of the study; members of the DIY tDCS community for input on the survey; Dawei Xie for statistical support; Jonathan Reisman, Peter Reiner, and the two anonymous reviewers for their comments; and the seven direct-to-consumer tDCS companies who participated in this study.
Conflict of Interest
The author declares that she has no conflict of interest.
Electronic Supplementary Material
About this article
Cite this article
Wexler, A. Who Uses Direct-to-Consumer Brain Stimulation Products, and Why? A Study of Home Users of tDCS Devices. J Cogn Enhanc 2, 114–134 (2018). https://doi.org/10.1007/s41465-017-0062-z
- Transcranial direct current stimulation
- Consumer neurotechnology
- Direct-to-consumer neuroscience