Mechanisms and Effects of Transcranial Direct Current Stimulation

Dose-Response: An International Journal January-March 2017:1-22 DOI: 10.1177/1559325816685467

James Giordano, Marom Bikson, Emily S. Kappenman, Vincent P. Clark, H. Branch Coslett, Michael R. Hamblin, Roy Hamilton, Ryan Jankord, Walter J. Kozumbo, R. Andrew McKinley, Michael A. Nitsche, J. Patrick Reilly, Jessica Richardson, Rachel Wurzman, and Edward Calabrese

Abstract: The US Air Force Office of Scientific Research convened a meeting of researchers in the fields of neuroscience, psychology, engineering, and medicine to discuss most pressing issues facing ongoing research in the field of transcranial direct current stimulation (tDCS) and related techniques. In this study, we present opinions prepared by participants of the meeting, focusing on the most promising areas of research, immediate and future goals for the field, and the potential for hormesis theory to inform tDCS research. Scientific, medical, and ethical considerations support the ongoing testing of tDCS in healthy and clinical popu- lations, provided best protocols are used to maximize safety. Notwithstanding the need for ongoing research, promising appli- cations include enhancing vigilance/attention in healthy volunteers, which can accelerate training and support learning. Commonly, tDCS is used as an adjunct to training/rehabilitation tasks with the goal of leftward shift in the learning/treatment effect curves. Although trials are encouraging, elucidating the basic mechanisms of tDCS will accelerate validation and adoption. To this end, biomarkers (eg, clinical neuroimaging and findings from animal models) can support hypotheses linking neurobiological mechanisms and behavioral effects. Dosage can be optimized using computational models of current flow and understanding dose–response. Both biomarkers and dosimetry should guide individualized interventions with the goal of reducing variability. Insights from other applied energy domains, including ionizing radiation, transcranial magnetic stimulation, and low-level laser (light) therapy, can be prudently leveraged.

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