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Safety of Transcranial Direct Current Stimulation

  • Pnina Grossman
  • Adam J. Woods
  • Helena Knotkova
  • Marom BiksonEmail author
Chapter

Abstract

This chapter reviews evidence on the safety of transcranial Direct Current Stimulation (tDCS) with the specific and limited definition of safety as the absence of evidence for a Serious Adverse Effect, the criteria of which are explained. The chapter adopts an evidence-based approach, using an aggregation of research experience from both animal studies and trials in human subjects. Safety data from animal tests for tissue damage are reviewed along with insight into how to relate animal dosage to human dosage. This includes utilizing computational models. The chapter presents relevant dose-response curves and dose metrics (including current, duration, current density, charge, charge density) for meaningful safety standards. Special consideration is given to populations that could be more vulnerable including children and the elderly, subjects with mood disorders, stroke, epilepsy, implants, and those employing at-home tDCS approach. The data summarized in this chapter support the conclusion reached by prior review that there is no evidence suggesting that conventional tDCS protocols, as commonly implemented in either healthy subjects or patient populations in clinical trials, increase risk of serious adverse events. Evidently, as with any novel treatment options, continuing research and vigilance are warranted. Based on the specific definition of safety set forth, the chapter on safety does not address tolerability or general issues related to adverse event monitoring. This chapter avoids specific recommendations or endorsements on protocols, but rather focuses on presenting the evidence for safety.

Keywords

Safety Transcranial direct current stimulation (tDCS) Adverse effects 

References

  1. Andrade, C. (2013). Once- to twice-daily, 3-year domiciliary maintenance transcranial direct current stimulation for severe, disabling, clozapine-refractory continuous auditory hallucinations in schizophrenia. The Journal of ECT, 29, 239–242. PubMedPubMedCentralCrossRefGoogle Scholar
  2. Antal, A., Alekseichuk, I., Bikson, M., Brockmöller, J., Brunoni, A. R., Chen, R., … Paulus, W. (2017). Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines. Clinical Neurophysiology, 128, 1774–1809. PubMedPubMedCentralCrossRefGoogle Scholar
  3. Anton, S. D., Woods, A. J., Ashizawa, T., Barb, D., Buford, T. W., Carter, C. S., … Pahor, M. (2015). Successful aging: Advancing the science of physical independence in older adults. Ageing Research Reviews, 24, 304–327. PubMedPubMedCentralCrossRefGoogle Scholar
  4. Aree-uea, B., Auvichayapat, N., Janyacharoen, T., Siritaratiwat, W., Amatachaya, A., Prasertnoo, J., … Auvichayapat, P. (2014). Reduction of spasticity in cerebral palsy by anodal transcranial direct current stimulation. Journal of the Medical Association of Thailand, 97, 954–962.Google Scholar
  5. Arul-Anandam, A. P., Loo, C., & Mitchell, P. (2010). Induction of hypomanic episode with transcranial direct current stimulation. The Journal of ECT, 26, 68–69. PubMedCrossRefPubMedCentralGoogle Scholar
  6. Auvichayapat, N., Rotenberg, A., Gersner, R., Ngodklang, S., Tiamkao, S., Tassaneeyakul, W., & Auvichayapat, P. (2013). Transcranial direct current stimulation for treatment of refractory childhood focal epilepsy. Brain Stimulation, 6, 696–700. PubMedCrossRefPubMedCentralGoogle Scholar
  7. Baba, T., Kameda, M., Yasuhara, T., Morimoto, T., Kondo, A., Shingo, T., … Date, I. (2009). Electrical stimulation of the cerebral cortex exerts antiapoptotic, angiogenic, and anti-inflammatory effects in ischemic stroke rats through phosphoinositide 3-kinase/Akt signaling pathway. Stroke, 40, e598–e605. Google Scholar
  8. Baccaro, A., Brunoni, A. R., Bensenor, I. M., & Fregni, F. (2010). Hypomanic episode in unipolar depression during transcranial direct current stimulation. Acta Neuropsychiatrica, 22, 316–318.CrossRefGoogle Scholar
  9. Benninger, D. H., Lomarev, M., Lopez, G., Wassermann, E. M., Li, X., Considine, E., & Hallett, M. (2010). Transcranial direct current stimulation for the treatment of Parkinson’s disease. Journal of Neurology, Neurosurgery, and Psychiatry, 81, 1105–1111. CrossRefGoogle Scholar
  10. Benvenuti, A., Rucci, P., Miniati, M., Papasogli, A., Fagiolini, A., Cassano, G. B., … Frank, E. (2008). Treatment-emergent mania/hypomania in unipolar patients. Bipolar Disorders, 10, 726–732. PubMedPubMedCentralCrossRefGoogle Scholar
  11. Berryhill, M. E., & Jones, K. T. (2012). tDCS selectively improves working memory in older adults with more education. Neuroscience Letters, 521, 148–151. CrossRefGoogle Scholar
  12. Bikson, M., Datta, A., & Elwassif, M. (2009). Establishing safety limits for transcranial direct current stimulation. Clinical Neurophysiology, 120, 1033–1034. PubMedPubMedCentralCrossRefGoogle Scholar
  13. Bikson, M., Datta, A., Rahman, A., & Scaturro, J. (2010). Electrode montages for tDCS and weak transcranial electrical stimulation: Role of “return” electrode’s position and size. Clinical Neurophysiology, 121, 1976–1978. PubMedPubMedCentralCrossRefGoogle Scholar
  14. Bikson, M., Grossman, P., Thomas, C., Zannou, A. L., Jiang, J., Adnan, T., … Woods, A. J. (2016). Safety of transcranial direct current stimulation: Evidence based update 2016. Brain Stimulation, 9, 641–661. Google Scholar
  15. Boggio, P. S., Campanhã, C., Valasek, C. A., Fecteau, S., Pascual-Leone, A., & Fregni, F. (2010). Modulation of decision-making in a gambling task in older adults with transcranial direct current stimulation. The European Journal of Neuroscience, 31, 593–597. CrossRefGoogle Scholar
  16. Boggio, P. S., Ferrucci, R., Mameli, F., Martins, D., Martins, O., Vergari, M., … Priori, A. (2012). Prolonged visual memory enhancement after direct current stimulation in Alzheimer’s disease. Brain Stimulation, 5, 223–230. CrossRefGoogle Scholar
  17. Boggio, P. S., Ferrucci, R., Rigonatti, S. P., Covre, P., Nitsche, M., Pascual-Leone, A., & Fregni, F. (2006). Effects of transcranial direct current stimulation on working memory in patients with Parkinson’s disease. Journal of the Neurological Sciences, 249, 31–38. CrossRefGoogle Scholar
  18. Boggio, P. S., Khoury, L. P., Martins, D. C. S., Covre, P., Nitsche, M., Pascual-Leone, A., & Fregni, F. (2009). Temporal cortex direct current stimulation enhances performance on a visual recognition memory task in Alzheimer disease. Journal of Neurology, Neurosurgery, and Psychiatry, 80, 444–447. CrossRefGoogle Scholar
  19. Brunoni, A. R., Amadera, J., Berbel, B., Volz, M. S., Rizzerio, B. G., & Fregni, F. (2011a). A systematic review on reporting and assessment of adverse effects associated with transcranial direct current stimulation. The International Journal of Neuropsychopharmacology, 14, 1133–1145. CrossRefGoogle Scholar
  20. Brunoni, A. R., Nitsche, M. A., Bolognini, N., Bikson, M., Wagner, T., Merabet, L., … Fregni, F. (2012). Clinical research with transcranial direct current stimulation (tDCS): Challenges and future directions. Brain Stimulation, 5, 175–195. CrossRefGoogle Scholar
  21. Brunoni, A. R., Valiengo, L., Baccaro, A., Zanão, T. A., de Oliveira, J. F., Goulart, A., … Fregni, F. (2013). The sertraline vs. electrical current therapy for treating depression clinical study: Results from a factorial, randomized, controlled trial. JAMA Psychiatry, 70, 383–391. PubMedPubMedCentralCrossRefGoogle Scholar
  22. Brunoni, A. R., Valiengo, L., Zanao, T., de Oliveira, J. F., Bensenor, I. M., & Fregni, F. (2011b). Manic psychosis after sertraline and transcranial direct-current stimulation. The Journal of Neuropsychiatry and Clinical Neurosciences, 23, E4–E5. CrossRefGoogle Scholar
  23. Calabrese, E. J. (2016). Preconditioning is hormesis part I: Documentation, dose-response features and mechanistic foundations. Pharmacological Research, 110, 242–264. PubMedCrossRefPubMedCentralGoogle Scholar
  24. Calabrese, E. J., Dhawan, G., Kapoor, R., Iavicoli, I., & Calabrese, V. (2015). HORMESIS: A fundamental concept with widespread biological and biomedical applications. Gerontology, 62, 530–535. PubMedCrossRefPubMedCentralGoogle Scholar
  25. Chang, W.-J., Bennell, K. L., Hodges, P. W., Hinman, R. S., Liston, M. B., & Schabrun, S. M. (2015). Combined exercise and transcranial direct current stimulation intervention for knee osteoarthritis: Protocol for a pilot randomised controlled trial. BMJ Open, 5, e008482. PubMedPubMedCentralCrossRefGoogle Scholar
  26. Charvet, L. E., Kasschau, M., Datta, A., Knotkova, H., Stevens, M. C., Alonzo, A., … Bikson, M. (2015). Remotely-supervised transcranial direct current stimulation (tDCS) for clinical trials: Guidelines for technology and protocols. Frontiers in Systems Neuroscience, 9(26). Google Scholar
  27. Cho, H.-S., & Cha, H.-G. (2015). Effect of mirror therapy with tDCS on functional recovery of the upper extremity of stroke patients. Journal of Physical Therapy Science, 27, 1045–1047. PubMedPubMedCentralCrossRefGoogle Scholar
  28. Cosmo, C., Baptista, A. F., & de Sena, E. P. (2015). Contribution of transcranial direct current stimulation on inhibitory control to assess the neurobiological aspects of attention deficit hyperactivity disorder: Randomized controlled trial. JMIR Research Protocols, 4, e56. PubMedPubMedCentralCrossRefGoogle Scholar
  29. Cotelli, M., Manenti, R., Brambilla, M., Petesi, M., Rosini, S., Ferrari, C., … Miniussi, C. (2014a). Anodal tDCS during face-name associations memory training in Alzheimer’s patients. Frontiers in Aging Neuroscience, 6, 38. Google Scholar
  30. Cotelli, M., Manenti, R., Petesi, M., Brambilla, M., Cosseddu, M., Zanetti, O., … Borroni, B. (2014b). Treatment of primary progressive aphasias by transcranial direct current stimulation combined with language training. Journal of Alzheimer’s Disease, 39, 799–808. PubMedPubMedCentralCrossRefGoogle Scholar
  31. Dasilva, A. F., Volz, M. S., Bikson, M., & Fregni, F. (2011). Electrode positioning and montage in transcranial direct current stimulation. Journal of Visualized Experiments. Google Scholar
  32. Datta, A., Baker, J. M., Bikson, M., & Fridriksson, J. (2011). Individualized model predicts brain current flow during transcranial direct-current stimulation treatment in responsive stroke patient. Brain Stimulation, 4, 169–174. CrossRefGoogle Scholar
  33. Datta, A., Bansal, V., Diaz, J., Patel, J., Reato, D., & Bikson, M. (2009). Gyri-precise head model of transcranial direct current stimulation: Improved spatial focality using a ring electrode versus conventional rectangular pad. Brain Stimulation, 2, 201–207, 207.e1. CrossRefGoogle Scholar
  34. Datta, A., Bikson, M., & Fregni, F. (2010). Transcranial direct current stimulation in patients with skull defects and skull plates: High-resolution computational FEM study of factors altering cortical current flow. NeuroImage, 52, 1268–1278. PubMedPubMedCentralCrossRefGoogle Scholar
  35. Dmochowski, J. P., Bikson, M., Datta, A., Richardson, J., Fridriksson, J., & Parra, L. C. (2012). On the role of electric field orientation in optimal design of transcranial current stimulation. Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2012, 6426–6429. Google Scholar
  36. Dmochowski, J. P., Datta, A., Bikson, M., Su, Y., & Parra, L. C. (2011). Optimized multi-electrode stimulation increases focality and intensity at target. Journal of Neural Engineering, 8, 046011. PubMedPubMedCentralCrossRefGoogle Scholar
  37. Dmochowski, J. P., Datta, A., Huang, Y., Richardson, J. D., Bikson, M., Fridriksson, J., & Parra, L. C. (2013). Targeted transcranial direct current stimulation for rehabilitation after stroke. NeuroImage, 75, 12–19. PubMedPubMedCentralCrossRefGoogle Scholar
  38. Doruk, D., Gray, Z., Bravo, G. L., Pascual-Leone, A., & Fregni, F. (2014). Effects of tDCS on executive function in Parkinson’s disease. Neuroscience Letters, 582, 27–31. PubMedPubMedCentralCrossRefGoogle Scholar
  39. Duarte Nde, A. C., Grecco, L. A. C., Galli, M., Fregni, F., & Oliveira, C. S. (2014). Effect of transcranial direct-current stimulation combined with treadmill training on balance and functional performance in children with cerebral palsy: A double-blind randomized controlled trial. PLoS One, 9, e105777. PubMedCentralCrossRefGoogle Scholar
  40. Edwards, D., Cortes, M., Datta, A., Minhas, P., Wassermann, E. M., & Bikson, M. (2013). Physiological and modeling evidence for focal transcranial electrical brain stimulation in humans: A basis for high-definition tDCS. NeuroImage, 74, 266–275. PubMedPubMedCentralCrossRefGoogle Scholar
  41. Elder, G. J., Firbank, M. J., Kumar, H., Chatterjee, P., Chakraborty, T., Dutt, A., & Taylor, J. P. (2015). Effects of transcranial direct current stimulation upon attention and visuoperceptual function in Lewy body dementia: A preliminary study. International Psychogeriatrics, 28, 1–7. PubMedPubMedCentralCrossRefGoogle Scholar
  42. Elder, G. J., & Taylor, J.-P. (2014). Transcranial magnetic stimulation and transcranial direct current stimulation: Treatments for cognitive and neuropsychiatric symptoms in the neurodegenerative dementias? Alzheimer's Research & Therapy, 6, 74. Google Scholar
  43. Esmaeilpour, Z., Milosevic, M., Azevedo, K., Khadka, N., Navarro, J., & Brunoni, A. (2017). Proceedings #21. Intracranial voltage recording during transcranial direct current stimulation (tDCS) in human subjects with validation of a standard model. Brain Stimulation, 10, e72–e75. CrossRefGoogle Scholar
  44. Faria, P., Fregni, F., Sebastião, F., Dias, A. I., & Leal, A. (2012). Feasibility of focal transcranial DC polarization with simultaneous EEG recording: Preliminary assessment in healthy subjects and human epilepsy. Epilepsy & Behavior, 25, 417–425. CrossRefGoogle Scholar
  45. Ferrucci, R., Mameli, F., Guidi, I., Mrakic-Sposta, S., Vergari, M., Marceglia, S., … Priori, A. (2008). Transcranial direct current stimulation improves recognition memory in Alzheimer disease. Neurology, 71, 493–498. PubMedPubMedCentralCrossRefGoogle Scholar
  46. Fertonani, A., Brambilla, M., Cotelli, M., & Miniussi, C. (2014). The timing of cognitive plasticity in physiological aging: A tDCS study of naming. Frontiers in Aging Neuroscience, 6, 131. Google Scholar
  47. Flöel, A., Suttorp, W., Kohl, O., Kürten, J., Lohmann, H., Breitenstein, C., & Knecht, S. (2012). Non-invasive brain stimulation improves object-location learning in the elderly. Neurobiology of Aging, 33, 1682–1689. CrossRefGoogle Scholar
  48. Frank, E., Wilfurth, S., Landgrebe, M., Eichhammer, P., Hajak, G., & Langguth, B. (2010). Anodal skin lesions after treatment with transcranial direct current stimulation. Brain Stimulation, 3, 58–59. PubMedCrossRefPubMedCentralGoogle Scholar
  49. Fregni, F., Boggio, P. S., Santos, M. C., Lima, M., Vieira, A. L., Rigonatti, S. P., … Pascual-Leone, A. (2006a). Noninvasive cortical stimulation with transcranial direct current stimulation in Parkinson’s disease. Movement Disorders, 21, 1693–1702. PubMedPubMedCentralCrossRefGoogle Scholar
  50. Fregni, F., Nitsche, M. A., Loo, C. K., Brunoni, A. R., Marangolo, P., Leite, J., … Bikson, M. (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, 22–35. PubMedCentralCrossRefGoogle Scholar
  51. Fregni, F., Thome-Souza, S., Nitsche, M. A., Freedman, S. D., Valente, K. D., & Pascual-Leone, A. (2006b). A controlled clinical trial of cathodal DC polarization in patients with refractory epilepsy. Epilepsia, 47, 335–342. PubMedCrossRefPubMedCentralGoogle Scholar
  52. Fusco, A., Assenza, F., Iosa, M., Izzo, S., Altavilla, R., Paolucci, S., & Vernieri, F. (2014a). The ineffective role of cathodal tDCS in enhancing the functional motor outcomes in early phase of stroke rehabilitation: An experimental trial. BioMed Research International, 2014, 547290. Google Scholar
  53. Fusco, A., Iosa, M., Venturiero, V., De Angelis, D., Morone, G., Maglione, L., … Paolucci, S. (2014b). After vs. priming effects of anodal transcranial direct current stimulation on upper extremity motor recovery in patients with subacute stroke. Restorative Neurology and Neuroscience, 32, 301–312. Google Scholar
  54. Gálvez, V., Alonzo, A., Martin, D., Mitchell, P. B., Sachdev, P., & Loo, C. K. (2011). Hypomania induction in a patient with bipolar II disorder by transcranial direct current stimulation (tDCS). The Journal of ECT, 27, 256–258. PubMedCrossRefPubMedCentralGoogle Scholar
  55. Gálvez, V., Ho, K.-A., Alonzo, A., Martin, D., George, D., & Loo, C. K. (2015). Neuromodulation therapies for geriatric depression. Current Psychiatry Reports, 17, 59. Google Scholar
  56. Gillick, B. T., Feyma, T., Menk, J., Usset, M., Vaith, A., Wood, T. J., … Krach, L. E. (2015). Safety and feasibility of transcranial direct current stimulation in pediatric hemiparesis: Randomized controlled preliminary study. Physical Therapy, 95, 337–349. PubMedPubMedCentralCrossRefGoogle Scholar
  57. Gillick, B. T., Kirton, A., Carmel, J. B., Minhas, P., & Bikson, M. (2014). Pediatric stroke and transcranial direct current stimulation: Methods for rational individualized dose optimization. Frontiers in Human Neuroscience, 8, 739. Google Scholar
  58. Goodwill, A. M., Reynolds, J., Daly, R. M., & Kidgell, D. J. (2013). Formation of cortical plasticity in older adults following tDCS and motor training. Frontiers in Aging Neuroscience, 5, 87. Google Scholar
  59. Grecco, L. A. C., de Almeida Carvalho Duarte, N., Mendonça, M. E., Cimolin, V., Galli, M., Fregni, F., & Santos Oliveira, C. (2014a). Transcranial direct current stimulation during treadmill training in children with cerebral palsy: A randomized controlled double-blind clinical trial. Research in Developmental Disabilities, 35, 2840–2848. PubMedCrossRefPubMedCentralGoogle Scholar
  60. Grecco, L. A. C., Duarte, N. A. C., Zanon, N., Galli, M., Fregni, F., & Oliveira, C. S. (2014b). Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study. Brazilian Journal of Physical Therapy, 18, 419–427.PubMedPubMedCentralCrossRefGoogle Scholar
  61. Grecco, L. A. C., Mendonça, M. E., Duarte, N. A. C., Zanon, N., Fregni, F., & Oliveira, C. S. (2014c). Transcranial direct current stimulation combined with treadmill gait training in delayed neuro-psychomotor development. Journal of Physical Therapy Science, 26, 945–950. PubMedPubMedCentralCrossRefGoogle Scholar
  62. Guarienti, F., Caumo, W., Shiozawa, P., Cordeiro, Q., Boggio, P. S., Benseñor, I. M., … Brunoni, A. R. (2015). Reducing transcranial direct current stimulation-induced erythema with skin pretreatment: Considerations for sham-controlled clinical trials. Neuromodulation, 18, 261–265. CrossRefGoogle Scholar
  63. Hagenacker, T., Bude, V., Naegel, S., Holle, D., Katsarava, Z., Diener, H. C., & Obermann, M. (2014). Patient-conducted anodal transcranial direct current stimulation of the motor cortex alleviates pain in trigeminal neuralgia. The Journal of Headache and Pain, 15, 78. Google Scholar
  64. Hardwick, R. M., & Celnik, P. A. (2014). Cerebellar direct current stimulation enhances motor learning in older adults. Neurobiology of Aging, 35, 2217–2221. PubMedPubMedCentralCrossRefGoogle Scholar
  65. Harty, S., Robertson, I. H., Miniussi, C., Sheehy, O. C., Devine, C. A., McCreery, S., & O’Connell, R. G. (2014). Transcranial direct current stimulation over right dorsolateral prefrontal cortex enhances error awareness in older age. The Journal of Neuroscience, 34, 3646–3652. PubMedPubMedCentralCrossRefGoogle Scholar
  66. Ho, K.-A., Bai, S., Martin, D., Alonzo, A., Dokos, S., & Loo, C. K. (2015). Clinical pilot study and computational modeling of Bitemporal transcranial direct current stimulation, and safety of repeated courses of treatment, in major depression. The Journal of ECT, 31, 226–233. PubMedCrossRefPubMedCentralGoogle Scholar
  67. Holland, R., Leff, A. P., Josephs, O., Galea, J. M., Desikan, M., Price, C. J., … Crinion, J. (2011). Speech facilitation by left inferior frontal cortex stimulation. Current Biology, 21, 1403–1407. PubMedPubMedCentralCrossRefGoogle Scholar
  68. Hsu, W.-Y., Ku, Y., Zanto, T. P., & Gazzaley, A. (2015). Effects of noninvasive brain stimulation on cognitive function in healthy aging and Alzheimer’s disease: A systematic review and meta-analysis. Neurobiology of Aging, 36, 2348–2359. PubMedPubMedCentralCrossRefGoogle Scholar
  69. Huang, Y., Liu, A. A., Lafon, B., Friedman, D., Dayan, M., Wang, X., … Parra, L. C. (2017). Measurements and models of electric fields in the in vivo human brain during transcranial electric stimulation. eLife, 6, e18834. Google Scholar
  70. Jones, K. T., Stephens, J. A., Alam, M., Bikson, M., & Berryhill, M. E. (2015). Longitudinal neurostimulation in older adults improves working memory. PLoS One, 10, e0121904. PubMedPubMedCentralCrossRefGoogle Scholar
  71. Kaski, D., Dominguez, R. O., Allum, J. H., Islam, A. F., & Bronstein, A. M. (2014). Combining physical training with transcranial direct current stimulation to improve gait in Parkinson’s disease: A pilot randomized controlled study. Clinical Rehabilitation, 28, 1115–1124. PubMedCrossRefPubMedCentralGoogle Scholar
  72. Kasschau, M., Sherman, K., Haider, L., Frontario, A., Shaw, M., Datta, A., … Charvet, L. (2015). A protocol for the use of remotely-supervised transcranial direct current stimulation (tDCS) in multiple sclerosis (MS). Journal of Visualized Experiments. Google Scholar
  73. Kessler, S. K., Minhas, P., Woods, A. J., Rosen, A., Gorman, C., & Bikson, M. (2013). Dosage considerations for transcranial direct current stimulation in children: A computational modeling study. PLoS One, 8, e76112. PubMedPubMedCentralCrossRefGoogle Scholar
  74. Kessler, S. K., Turkeltaub, P. E., Benson, J. G., & Hamilton, R. H. (2012). Differences in the experience of active and sham transcranial direct current stimulation. Brain Stimulation, 5, 155–162. CrossRefGoogle Scholar
  75. Khedr, E. M., Gamal, N. F. E., El-Fetoh, N. A., Khalifa, H., Ahmed, E. M., Ali, A. M., … Karim, A. A. (2014). A double-blind randomized clinical trial on the efficacy of cortical direct current stimulation for the treatment of Alzheimer’s disease. Frontiers in Aging Neuroscience, 6, 275. Google Scholar
  76. Kim, S. J., Kim, B. K., Ko, Y. J., Bang, M. S., Kim, M. H., & Han, T. R. (2010). Functional and histologic changes after repeated transcranial direct current stimulation in rat stroke model. Journal of Korean Medical Science, 25, 1499–1505. PubMedPubMedCentralCrossRefGoogle Scholar
  77. Kim, Y. J., Ku, J., Cho, S., Kim, H. J., Cho, Y. K., Lim, T., & Kang, Y. J. (2014). Facilitation of corticospinal excitability by virtual reality exercise following anodal transcranial direct current stimulation in healthy volunteers and subacute stroke subjects. Journal of Neuroengineering and Rehabilitation, 11, 124. PubMedPubMedCentralCrossRefGoogle Scholar
  78. Kronberg, G., & Bikson, M. (2012). Electrode assembly design for transcranial direct current stimulation: A FEM modeling study. Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2012, 891–895. Google Scholar
  79. Laakso, I., & Hirata, A. (2013). Computational analysis shows why transcranial alternating current stimulation induces retinal phosphenes. Journal of Neural Engineering, 10, 046009. PubMedCrossRefPubMedCentralGoogle Scholar
  80. Lee, S. J., & Chun, M. H. (2014). Combination transcranial direct current stimulation and virtual reality therapy for upper extremity training in patients with subacute stroke. Archives of Physical Medicine and Rehabilitation, 95, 431–438. PubMedCrossRefPubMedCentralGoogle Scholar
  81. Liebetanz, D., Koch, R., Mayenfels, S., König, F., Paulus, W., & Nitsche, M. A. (2009). Safety limits of cathodal transcranial direct current stimulation in rats. Clinical Neurophysiology, 120, 1161–1167. CrossRefGoogle Scholar
  82. Loo, C. K., Alonzo, A., Martin, D., Mitchell, P. B., Galvez, V., & Sachdev, P. (2012). Transcranial direct current stimulation for depression: 3-week, randomised, sham-controlled trial. The British Journal of Psychiatry, 200, 52–59. PubMedCrossRefPubMedCentralGoogle Scholar
  83. Manenti, R., Bianchi, M., Cosseddu, M., Brambilla, M., Rizzetti, C., Padovani, A., … Cotelli, M. (2015). Anodal transcranial direct current stimulation of parietal cortex enhances action naming in Corticobasal Syndrome. Frontiers in Aging Neuroscience, 7, 49. Google Scholar
  84. Manenti, R., Brambilla, M., Petesi, M., Ferrari, C., & Cotelli, M. (2013). Enhancing verbal episodic memory in older and young subjects after non-invasive brain stimulation. Frontiers in Aging Neuroscience, 5, 49. Google Scholar
  85. Manenti, R., Brambilla, M., Rosini, S., Orizio, I., Ferrari, C., Borroni, B., & Cotelli, M. (2014). Time up and go task performance improves after transcranial direct current stimulation in patient affected by Parkinson’s disease. Neuroscience Letters, 580, 74–77. PubMedCrossRefPubMedCentralGoogle Scholar
  86. Mattai, A., Miller, R., Weisinger, B., Greenstein, D., Bakalar, J., Tossell, J., … Gogtay, N. (2011). Tolerability of transcranial direct current stimulation in childhood-onset schizophrenia. Brain Stimulation, 4, 275–280. PubMedPubMedCentralCrossRefGoogle Scholar
  87. Mcintire, L. K., Mckinley, R. A., Goodyear, C., & Nelson, J. (2014). A comparison of the effects of transcranial direct current stimulation and caffeine on vigilance and cognitive performance during extended wakefulness. Brain Stimulation, 7, 499–507. Google Scholar
  88. Medeiros, L. F., de Souza, I. C. C., Vidor, L. P., de Souza, A., Deitos, A., Volz, M. S., … Torres, I. L. (2012). Neurobiological effects of transcranial direct current stimulation: A review. Frontiers in Psychiatry, 3, 110. Google Scholar
  89. Meinzer, M., Lindenberg, R., Antonenko, D., Flaisch, T., & Flöel, A. (2013). Anodal transcranial direct current stimulation temporarily reverses age-associated cognitive decline and functional brain activity changes. The Journal of Neuroscience, 33, 12470–12478. PubMedPubMedCentralCrossRefGoogle Scholar
  90. Meinzer, M., Lindenberg, R., Sieg, M. M., Nachtigall, L., Ulm, L., & Flöel, A. (2014). Transcranial direct current stimulation of the primary motor cortex improves word-retrieval in older adults. Frontiers in Aging Neuroscience, 6, 253. Google Scholar
  91. Mekonnen, A., Salvador, R., Ruffini, G., & Miranda, P. C. (2012). The relationship between transcranial current stimulation electrode montages and the effect of the skull orbital openings. Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2012, 831–834. Google Scholar
  92. Mielke, D., Wrede, A., Schulz-Schaeffer, W., Taghizadeh-Waghefi, A., Nitsche, M. A., Rohde, V., & Liebetanz, D. (2013). Cathodal transcranial direct current stimulation induces regional, long-lasting reductions of cortical blood flow in rats. Neurological Research, 35, 1029–1037. PubMedCrossRefPubMedCentralGoogle Scholar
  93. Minhas, P., Bansal, V., Patel, J., Ho, J. S., Diaz, J., Datta, A., & Bikson, M. (2010). Electrodes for high-definition transcutaneous DC stimulation for applications in drug delivery and electrotherapy, including tDCS. Journal of Neuroscience Methods, 190, 188–197. PubMedPubMedCentralCrossRefGoogle Scholar
  94. Minhas, P., Datta, A., & Bikson, M. (2011). Cutaneous perception during tDCS: Role of electrode shape and sponge salinity. Clinical Neurophysiology, 122, 637–638. CrossRefGoogle Scholar
  95. Moffa, A. H., Brunoni, A. R., Fregni, F., Palm, U., Padberg, F., Blumberger, D. M., … Loo, C. K. (2017). Safety and acceptability of transcranial direct current stimulation for the acute treatment of major depressive episodes: Analysis of individual patient data. Journal of Affective Disorders, 221, 1–5. PubMedCrossRefPubMedCentralGoogle Scholar
  96. Monte-Silva, K., Kuo, M.-F., Hessenthaler, S., Fresnoza, S., Liebetanz, D., Paulus, W., & Nitsche, M. A. (2013). Induction of late LTP-like plasticity in the human motor cortex by repeated non-invasive brain stimulation. Brain Stimulation, 6, 424–432. PubMedPubMedCentralCrossRefGoogle Scholar
  97. Morales-Quezada, L., Cosmo, C., Carvalho, S., Leite, J., Castillo-Saavedra, L., Rozisky, J. R., & Fregni, F. (2015). Cognitive effects and autonomic responses to transcranial pulsed current stimulation. Experimental Brain Research, 233, 701–709. CrossRefGoogle Scholar
  98. Mortensen, J., Figlewski, K., & Andersen, H. (2015). Combined transcranial direct current stimulation and home-based occupational therapy for upper limb motor impairment following intracerebral hemorrhage: A double-blind randomized controlled trial. Disability and Rehabilitation, 38, 1–7. PubMedCrossRefPubMedCentralGoogle Scholar
  99. Nitsche, M. A., Bikson, M., & Bestmann, S. (2015). On the use of meta-analysis in Neuromodulatory non-invasive brain stimulation. Brain Stimulation, 8, 666–667. PubMedCrossRefPubMedCentralGoogle Scholar
  100. Nitsche, M. A., Doemkes, S., Karaköse, T., Antal, A., Liebetanz, D., Lang, N., … Paulus, W. (2007). Shaping the effects of transcranial direct current stimulation of the human motor cortex. Journal of Neurophysiology, 97, 3109–3117. PubMedPubMedCentralCrossRefGoogle Scholar
  101. Nitsche, M. A., Liebetanz, D., Lang, N., Antal, A., Tergau, F., & Paulus, W. (2003). Safety criteria for transcranial direct current stimulation (tDCS) in humans. Clinical Neurophysiology, 114, 2220–2222; author reply 2222–2223.PubMedPubMedCentralCrossRefGoogle Scholar
  102. Nitsche, M. A., Niehaus, L., Hoffmann, K. T., Hengst, S., Liebetanz, D., Paulus, W., & Meyer, B. U. (2004). MRI study of human brain exposed to weak direct current stimulation of the frontal cortex. Clinical Neurophysiology, 115, 2419–2423. PubMedCrossRefPubMedCentralGoogle Scholar
  103. Opitz, A., Falchier, A., Yan, C.-G., Yeagle, E., Linn, G., Megevand, P., … Schroeder, C. (2016). Spatiotemporal structure of intracranial electric fields induced by transcranial electric stimulation in humans and nonhuman primates. Scientific Reports, 6, 31236. Google Scholar
  104. Opitz, A., Paulus, W., Will, S., Antunes, A., & Thielscher, A. (2015). Determinants of the electric field during transcranial direct current stimulation. NeuroImage, 109, 140–150. CrossRefGoogle Scholar
  105. Palm, U., Feichtner, K. B., Hasan, A., Gauglitz, G., Langguth, B., Nitsche, M. A., … Padberg, F. (2014). The role of contact media at the skin-electrode interface during transcranial direct current stimulation (tDCS). Brain Stimulation, 7, 762–764. PubMedCrossRefPubMedCentralGoogle Scholar
  106. Paneri, B., Khadka, N., Patel, V., Thomas, C., Tyler, W., Parra, L. C., & Bikson, M. (2015). The tolerability of transcranial electrical stimulation used across extended periods in a naturalistic context by healthy individuals. PeerJ Prepr, 3 Google Scholar
  107. Parazzini, M., Rossi, E., Rossi, L., Priori, A., & Ravazzani, P. (2013). Numerical estimation of the current density in the heart during transcranial direct current stimulation. Brain Stimulation, 6, 457–459. CrossRefGoogle Scholar
  108. Parikh, P. J., & Cole, K. J. (2015). Effects of transcranial direct current stimulation on the control of finger force during dexterous manipulation in healthy older adults. PLoS One, 10, e0124137. PubMedPubMedCentralCrossRefGoogle Scholar
  109. Park, S.-H., Seo, J.-H., Kim, Y.-H., & Ko, M.-H. (2014). Long-term effects of transcranial direct current stimulation combined with computer-assisted cognitive training in healthy older adults. Neuroreport, 25, 122–126. CrossRefGoogle Scholar
  110. Peruzzotti-Jametti, L., Cambiaghi, M., Bacigaluppi, M., Gallizioli, M., Gaude, E., Mari, S., … Leocani, L. (2013). Safety and efficacy of transcranial direct current stimulation in acute experimental ischemic stroke. Stroke, 44, 3166–3174. PubMedCrossRefPubMedCentralGoogle Scholar
  111. Pirulli, C., Fertonani, A., & Miniussi, C. (2014). Is neural hyperpolarization by cathodal stimulation always detrimental at the behavioral level? Frontiers in Behavioral Neuroscience, 8, 226. Google Scholar
  112. Poreisz, C., Boros, K., Antal, A., & Paulus, W. (2007). Safety aspects of transcranial direct current stimulation concerning healthy subjects and patients. Brain Research Bulletin, 72, 208–214. PubMedPubMedCentralCrossRefGoogle Scholar
  113. Puri, R., Hinder, M. R., Fujiyama, H., Gomez, R., Carson, R. G., & Summers, J. J. (2015). Duration-dependent effects of the BDNF Val66Met polymorphism on anodal tDCS induced motor cortex plasticity in older adults: A group and individual perspective. Frontiers in Aging Neuroscience, 7, 107. Google Scholar
  114. Raimundo, R. J. S., Uribe, C. E., & Brasil-Neto, J. P. (2012). Lack of clinically detectable acute changes on autonomic or thermoregulatory functions in healthy subjects after transcranial direct current stimulation (tDCS). Brain Stimulation, 5, 196–200. PubMedCrossRefPubMedCentralGoogle Scholar
  115. Rampersad, S. M., Janssen, A. M., Lucka, F., Aydin, Ü., Lanfer, B., Lew, S., … Oostendorp, T. F. (2014). Simulating transcranial direct current stimulation with a detailed anisotropic human head model. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 22, 441–452. CrossRefGoogle Scholar
  116. Rodríguez, N., Opisso, E., Pascual-Leone, A., & Soler, M. D. (2014). Skin lesions induced by transcranial direct current stimulation (tDCS). Brain Stimulation, 7, 765–767. PubMedCrossRefPubMedCentralGoogle Scholar
  117. Ross, L. A., McCoy, D., Coslett, H. B., Olson, I. R., & Wolk, D. A. (2011). Improved proper name recall in aging after electrical stimulation of the anterior temporal lobes. Frontiers in Aging Neuroscience, 3, 16. Google Scholar
  118. Russo, R., Wallace, D., Fitzgerald, P. B., & Cooper, N. R. (2013). Perception of comfort during active and sham transcranial direct current stimulation: A double blind study. Brain Stimulation, 6, 946–951. PubMedCrossRefPubMedCentralGoogle Scholar
  119. Sadleir, R. J., Vannorsdall, T. D., Schretlen, D. J., & Gordon, B. (2010). Transcranial direct current stimulation (tDCS) in a realistic head model. NeuroImage, 51, 1310–1318. CrossRefGoogle Scholar
  120. Salthouse, T. A. (2010). Selective review of cognitive aging. Journal of the International Neuropsychological Society, 16, 754–760.PubMedPubMedCentralCrossRefGoogle Scholar
  121. Sandrini, M., Brambilla, M., Manenti, R., Rosini, S., Cohen, L. G., & Cotelli, M. (2014). Noninvasive stimulation of prefrontal cortex strengthens existing episodic memories and reduces forgetting in the elderly. Frontiers in Aging Neuroscience, 6, 289. Google Scholar
  122. San-Juan, D., Calcáneo J de, D. D. C., González-Aragón, M. F., Bermúdez Maldonado, L., Avellán, A. M., Argumosa, E. V., & Fregni, F. (2011a). Transcranial direct current stimulation in adolescent and adult Rasmussen’s encephalitis. Epilepsy & Behavior, 20, 126–131. CrossRefGoogle Scholar
  123. San-Juan, D., Mayorga, A. P. M., Anschel, D. J., Avellán, A. M., González-Aragón, M. F., & Cole, A. J. (2011b). The double generalization phenomenon in juvenile absence epilepsy. Epilepsy & Behavior, 21, 318–320. CrossRefGoogle Scholar
  124. San-Juan, D., Morales-Quezada, L., Orozco Garduño, A. J., Alonso-Vanegas, M., González-Aragón, M. F., Espinoza López, D. A., … Fregni, F. (2015). Transcranial direct current stimulation in epilepsy. Brain Stimulation, 8, 455–464. Google Scholar
  125. Sattler, V., Acket, B., Raposo, N., Albucher, J. F., Thalamas, C., Loubinoux, I., … Simonetta-Moreau, M. (2015). Anodal tDCS combined with radial nerve stimulation promotes hand motor recovery in the acute phase after ischemic stroke. Neurorehabilitation and Neural Repair, 29, 743–754. CrossRefGoogle Scholar
  126. Sawyer, D. W., Donowitz, G. R., & Mandell, G. L. (1989). Polymorphonuclear neutrophils: An effective antimicrobial force. Reviews of Infectious Diseases, 11(Suppl 7), S1532–S1544.CrossRefGoogle Scholar
  127. Shiozawa, P., da Silva, M. E., Raza, R., Uchida, R. R., Cordeiro, Q., Fregni, F., & Brunoni, A. R. (2013). Safety of repeated transcranial direct current stimulation in impaired skin: A case report. The Journal of ECT, 29, 147–148. PubMedCrossRefPubMedCentralGoogle Scholar
  128. Smit, M., Schutter, D. J. L. G., Nijboer, T. C. W., Visser-Meily, J. M., Kappelle, L. J., Kant, N., … Dijkerman, H. C. (2015). Transcranial direct current stimulation to the parietal cortex in hemispatial neglect: A feasibility study. Neuropsychologia, 74, 152–161. PubMedCrossRefPubMedCentralGoogle Scholar
  129. Stephen, L. J., & Brodie, M. J. (2000). Epilepsy in elderly people. Lancet, 355, 1441–1446. CrossRefGoogle Scholar
  130. Suemoto, C. K., Apolinario, D., Nakamura-Palacios, E. M., Lopes, L., Leite, R. E., Sales, M. C., … Fregni, F. (2014). Effects of a non-focal plasticity protocol on apathy in moderate Alzheimer’s disease: A randomized, double-blind, sham-controlled trial. Brain Stimulation, 7, 308–313. CrossRefGoogle Scholar
  131. Sundaram, A., Stock, V., Cruciani, R. A., & Knotkova, H. (2009). Safety of transcranial direct current stimulation (tDCS) in protocols involving human subjects. Journal of Pain Management, 2, 285–293.Google Scholar
  132. Tadini, L., El-Nazer, R., Brunoni, A. R., Williams, J., Carvas, M., Boggio, P., … Fregni, F. (2011). Cognitive, mood, and electroencephalographic effects of noninvasive cortical stimulation with weak electrical currents. The Journal of ECT, 27, 134–140. PubMedCrossRefPubMedCentralGoogle Scholar
  133. Tahtis, V., Kaski, D., & Seemungal, B. M. (2014). The effect of single session bi-cephalic transcranial direct current stimulation on gait performance in sub-acute stroke: A pilot study. Restorative Neurology and Neuroscience, 32, 527–532. Google Scholar
  134. Tippett, D. C., Hillis, A. E., & Tsapkini, K. (2015). Treatment of primary progressive aphasia. Current Treatment Options in Neurology, 17, 362. Google Scholar
  135. Vestito, L., Rosellini, S., Mantero, M., & Bandini, F. (2014). Long-term effects of transcranial direct-current stimulation in chronic post-stroke aphasia: A pilot study. Frontiers in Human Neuroscience, 8, 785. Google Scholar
  136. Wachter, D., Wrede, A., Schulz-Schaeffer, W., Taghizadeh-Waghefi, A., Nitsche, M. A., Kutschenko, A., … Liebetanz, D. (2011). Transcranial direct current stimulation induces polarity-specific changes of cortical blood perfusion in the rat. Experimental Neurology, 227, 322–327. PubMedCrossRefPubMedCentralGoogle Scholar
  137. Wang, J., Wei, Y., Wen, J., & Li, X. (2015). Skin burn after single session of transcranial direct current stimulation (tDCS). Brain Stimulation, 8, 165–166. PubMedCrossRefPubMedCentralGoogle Scholar
  138. Woods, A. J., Antal, A., Bikson, M., Boggio, P. S., Brunoni, A. R., Celnik, P., … Nitsche, M. A. (2015). A technical guide to tDCS, and related non-invasive brain stimulation tools. Clinical Neurophysiology, 127, 1031–1048. PubMedPubMedCentralCrossRefGoogle Scholar
  139. Wu, D., Wang, J., & Yuan, Y. (2015). Effects of transcranial direct current stimulation on naming and cortical excitability in stroke patients with aphasia. Neuroscience Letters, 589, 115–120. PubMedCrossRefPubMedCentralGoogle Scholar
  140. Yook, S.-W., Park, S.-H., Seo, J.-H., Kim, S. J., & Ko, M. H. (2011). Suppression of seizure by cathodal transcranial direct current stimulation in an epileptic patient – a case report. Annals of Rehabilitation Medicine, 35, 579–582. PubMedPubMedCentralCrossRefGoogle Scholar
  141. Young, S. J., Bertucco, M., Sheehan-Stross, R., & Sanger, T. D. (2013). Cathodal transcranial direct current stimulation in children with dystonia: A pilot open-label trial. Journal of Child Neurology, 28, 1238–1244. PubMedCrossRefPubMedCentralGoogle Scholar
  142. Zhou, D., Zhou, J., Chen, H., Manor, B., Lin, J., & Zhang, J. (2015). Effects of transcranial direct current stimulation (tDCS) on multiscale complexity of dual-task postural control in older adults. Experimental Brain Research, 233, 2401–2409. PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Pnina Grossman
    • 1
  • Adam J. Woods
    • 2
  • Helena Knotkova
    • 3
    • 4
  • Marom Bikson
    • 5
    Email author
  1. 1.Department of Biomedical EngineeringThe City College of the City University of New York, Grove School of EngineeringNew YorkUSA
  2. 2.Center for Cognitive Aging and Memory (CAM), McKnight Brain Institute, Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of FloridaGainesvilleUSA
  3. 3.MJHS Institute for Innovation in Palliative CareNew YorkUSA
  4. 4.Department of Family and Social MedicineAlbert Einstein College of MedicineBronxUSA
  5. 5.Department of Biomedical EngineeringThe City College of New YorkNew YorkUSA

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