scholarly journals Evidence-based guidelines and secondary meta-analysis for the use of transcranial direct current stimulation (tDCS) in neurological and psychiatric disorders

2020 ◽  
Author(s):  
Felipe Fregni ◽  
Mirret M El-Hagrassy ◽  
Kevin Pacheco-Barrios ◽  
Sandra Carvalho ◽  
Jorge Leite ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Motor Function ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Effect Sizes ◽  
Evidence Based ◽  
Clinical Effects ◽  
Direct Current Stimulation ◽  
Effective Level

Abstract Background Transcranial direct current stimulation (tDCS) has shown promising clinical results, leading to increased demand for an evidence-based review on its clinical effects. Objective We convened a team of tDCS experts to conduct a systematic review of clinical trials with more than one session of stimulation testing: Pain, Parkinson’s Disease Motor Function and Cognition, Stroke Motor Function and Language, Epilepsy, Major Depressive Disorder, Obsessive-Compulsive Disorder, Tourette Syndrome, Schizophrenia and Drug Addiction. Methods Experts were asked to conduct this systematic review according to the search methodology from PRISMA guidelines. Recommendations on efficacy were categorized into: Levels A (definitely effective), B (probably effective), C (possibly effective) or no recommendation. We assessed risk of bias for all included studies to confirm whether results were driven by potentially biased studies. Results Although most of the clinical trials have been designed as proof-of-concept trials, some of the indications analyzed in this review can be considered as definitely effective (Level A) such as depression, probably effective (Level B) such as neuropathic pain, fibromyalgia, migraine, post-operative patient-controlled analgesia and pain, Parkinson´s disease (motor and cognition), stroke (motor), epilepsy, schizophrenia and alcohol addiction. Assessment of bias showed that most of the studies had low risk of biases and sensitivity analysis for bias did not change these results. Effect sizes vary from 0.01 to 0.70 and were significant in about 8 conditions, with largest effect size being in postoperative acute pain, and smaller in stroke motor recovery (nonsignificant when combined with robotic therapy). Conclusion All recommendations listed here are based on current published Pubmed-indexed data. Despite high level of evidence in some conditions, it needs to be underscored that effect sizes and duration of effects are often limited; thus, real clinical impact needs to be further determined with different study designs.

scholarly journals The effects of transcranial direct current stimulation on objective and subjective indexes of exercise performance: a systematic review and meta-analysis.

2018 ◽  
Author(s):  
Darias Holgado ◽  
Miguel A. Vadillo ◽  
Daniel Sanabria
Keyword(s):  
Systematic Review ◽  
Direct Current ◽  
Exercise Performance ◽  
Transcranial Direct Current Stimulation ◽  
Perceived Exertion ◽  
Effect Sizes ◽  
Electrode Placement ◽  
Current Evidence ◽  
Time To Exhaustion ◽  
Direct Current Stimulation

Objective: To examine the effectss of transcranial direct current stimulation (tDCS) on objective and subjective indexes of exercise performance.Design: Systematic review and meta-analysis.Data Sources: A systematic literature search of electronic databases (PubMed, Web of Science, Scopus, Google Scholar) and reference lists of included articles up to June 2018.Eligibility Criteria: Published articles in journals or in repositories with raw data available, randomized sham-controlled trial comparing anodal stimulation with a sham condition providing data on objective (e.g. time to exhaustion or time-trial performance) or subjective (e.g. rate of perceived exertion) indexes of exercise performance.Results: The initial search provided 420 articles of which 31 were assessed for eligibility. Finally, the analysis of effect sizes comprised 24 studies with 386 participants. The analysis indicated that anodal tDCS had a small but positive effect on performance g = 0.34, 95% CI [0.12, 0.52], z = 3.24, p = 0.0012. Effects were not significantly moderated by type of outcome, electrode placement, muscles involved, number of sessions, or intensity and duration of the stimulation. Importantly, the funnel plot showed that, overall, effect sizes tended to be larger in studies with lower sample size and high standard error. Summary: The results suggest that tDCS may have a positive impact on exercise performance. However, the effect is probably small and most likely biased by low quality studies and the selective publication of significant results. Therefore, the current evidence does not provide strong support to the conclusion that tDCS is an effective means to improve exercise performance.

scholarly journals Transcranial Direct Current Stimulation for Parkinson's Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 13 ◽  
Author(s):  
Xiang Liu ◽  
Huiyu Liu ◽  
Zicai Liu ◽  
Jinzhu Rao ◽  
Jing Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Function ◽  
Direct Current ◽  
Effect Size ◽  
Transcranial Direct Current Stimulation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Direct Current Stimulation

Background: Parkinson's disease is a common neurodegenerative disorder with motor and non-motor symptoms. Recently, as adjuvant therapy, transcranial direct current stimulation (tDCS) has been shown to improve the motor and non-motor function of patients with Parkinson's disease (PD). This systematic review aimed to evaluate the existing evidence for the efficacy of tDCS for PD. We included English databases (PubMed, the Cochrane Library, Embase, and Web of Science) and Chinese databases [Wanfang database, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and China Biology Medicine (CBM)] without restricting the year of publication. Twenty-one tDCS studies, with a total of 736 participants, were included in the analysis. Two independent researchers extracted the data and characteristics of each study. There was a significant pooled effect size (−1.29; 95% CI = −1.60, −0.98; p < 0.00001; I2 = 0%) in the Unified PD Rating Scale (UPDRS) I and the Montreal cognitive assessment (SMD = 0.87, 95% CI = 0.50 to 1.24; p < 0.00001; I2 = 0%). The poor effect size was observed in the UPDRS III scores (SMD = −0.13; 95% CI = −0.64, 0.38; p = 0.61; I2 = 77%), and similar results were observed for the timed up and go (TUG) test, Berg balance scale, and gait assessment. The results of this meta-analysis showed that there was insufficient evidence that tDCS improves the motor function of patients with PD. However, tDCS seemed to improve their cognitive performance. Further multicenter research with a larger sample size is needed. In addition, future research should focus on determining the tDCS parameters that are most beneficial to the functional recovery of patients with PD.

scholarly journals Transcranial direct current stimulation for auditory verbal hallucinations: a systematic review of clinical trials

2021 ◽  
Vol 16 (4) ◽  
pp. 666
Author(s):  
Youguo Hao ◽  
Ali Yadollahpour ◽  
Samaneh Rashidi ◽  
Myles Jones ◽  
Eric Murillo-Rodriguez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Auditory Verbal Hallucinations ◽  
Direct Current Stimulation

scholarly journals Transcranial Direct Current Stimulation in the Management of Chronic Low Back Pain: A Systematic Review

2021 ◽  
Author(s):  
Carolina Gabriela Divino Soares Gioia ◽  
Caio de Almeida Lellis ◽  
Caio Reis Borges ◽  
Camila Puton ◽  
Giovanna Garcia de Oliveira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trial ◽  
Clinical Trials ◽  
Low Back Pain ◽  
Back Pain ◽  
Direct Current ◽  
Chronic Low Back Pain ◽  
Transcranial Direct Current Stimulation ◽  
Low Back ◽  
Direct Current Stimulation

Introduction: Chronic Low Back Pain is a condition associated with changes in different brain regions, related to pain, posture and emotions. Objectives: Review the current literature about the efficiency and safety of Transcranial Direct Current Stimulation in the management of Chronic Low Back Pain. Design and setting: This is a systematic review of the literature conducted at the Pontifical Catholic University of Goiás. Methods: A systematic review of literature was conducted in the PubMed, BVS and Lilacs databases, with the following research strategy: “(Transcranial Direct Current Stimulation or TDCS) and (Low Back Pain)”. Randomized studies, clinical trials and case reports published in the last 10 years were selected. Results: A clinical trial showed that TDCS of the primary motor cortex (M1) for 20 minutes improved posture, balance and pain intensity of patients with CLBP. Also, a randomized clinical trial concluded that this technique, at 2-mA intensity, showed a significant reduction in CLBP. On the other hand, two randomized clinical trials showed that the results obtained did not support the application of the TDCS method for the treatment of CLBP, since the observed groups did not show considerable difference after stimulation. In addition, another double-blind controlled study also showed that TDCS over M1 did not influence the quality of patients’ CLBP. Conclusion: A conflict was noticed between the conclusions of the articles used to compose this review, that’s why more studies with scientific rigor are needed.

scholarly journals Can Transcranial Direct Current Stimulation Enhance Functionality in Older Adults? A Systematic Review

2021 ◽  
Vol 10 (13) ◽  
pp. 2981
Author(s):  
Andrés Pino-Esteban ◽  
Álvaro Megía-García ◽  
David Martín-Caro Álvarez ◽  
Hector Beltran-Alacreu ◽  
Juan Avendaño-Coy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Randomized Clinical Trials ◽  
Scientific Evidence ◽  
Healthy Older Adults ◽  
Sham Stimulation ◽  
Direct Current Stimulation ◽  
Potential Benefits

Transcranial direct current stimulation (tDCS) is a non-invasive, easy to administer, well-tolerated, and safe technique capable of affecting brain excitability, both at the cortical and cerebellum levels. However, its effectiveness has not been sufficiently assessed in all population segments or clinical applications. This systematic review aimed at compiling and summarizing the currently available scientific evidence about the effect of tDCS on functionality in older adults over 60 years of age. A search of databases was conducted to find randomized clinical trials that applied tDCS versus sham stimulation in the above-mentioned population. No limits were established in terms of date of publication. A total of 237 trials were found, of which 24 met the inclusion criteria. Finally, nine studies were analyzed, including 260 healthy subjects with average age between 61.0 and 85.8 years. Seven of the nine included studies reported superior improvements in functionality variables following the application of tDCS compared to sham stimulation. Anodal tDCS applied over the motor cortex may be an effective technique for improving balance and posture control in healthy older adults. However, further high-quality randomized controlled trials are required to determine the most effective protocols and to clarify potential benefits for older adults.

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