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Transcranial Direct Current Stimulation: Protocols and Physiological Mechanisms of Action

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Textbook of Neuromodulation

Abstract

Tonic stimulation with direct currents (transcranial direct current stimulation [tDCS]) was reintroduced about a decade ago as a method to modulate cortical excitability, activity, and to elicit neuroplasticity in the human brain. tDCS alters cortical excitability for up to hours after the end of stimulation, depending on its duration and intensity. While anodal stimulation increases excitability, cathodal stimulation reduces it. Beyond these local effects under the electrodes, an impact of tDCS on cortical networks was revealed recently. During the last 12 years, tDCS has been demonstrated to modify perceptual, motor, and cognitive functions reversibly in healthy subjects. Moreover, the results of clinical pilot studies suggest its suitability as a treatment in neurological and psychiatric diseases. This review will give an overview of the principles of tDCS. It will be discussed how specific stimulation parameters, like stimulation intensity, duration, electrode size, and configuration, including recently developed new stimulation protocols, determine the direction, magnitude, and duration of effects. Moreover, an overview of the main putative regional and network physiological mechanisms will be given.

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Acknowledgements

M.A.N. receives funding by the German Research Society (DFG) via grants Ni 683/4-2, and Ni 683/6-1.

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Authors and Affiliations

  1. Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Robert-Koch-Str. 40, Goettingen, 37099, Germany

    Michael A. Nitsche, Min-Fang Kuo, Walter Paulus & Andrea Antal

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  1. Michael A. Nitsche
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  2. Min-Fang Kuo
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Correspondence to Michael A. Nitsche .

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  1. Institute for Innovation in Palliative Care, Metropolitan Jewish Health Systems (MJHS), New York, New York, USA

    Helena Knotkova

  2. University of Lübeck, Department of Neurosurgery University Hospital of Schleswig-Holstein, Lübeck, Germany

    Dirk Rasche

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Nitsche, M.A., Kuo, MF., Paulus, W., Antal, A. (2015). Transcranial Direct Current Stimulation: Protocols and Physiological Mechanisms of Action. In: Knotkova, H., Rasche, D. (eds) Textbook of Neuromodulation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1408-1_9

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