Clinicians Warn Against DIY Transcranial Direct Current Stimulation

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Clinicians Warn Against DIY Transcranial Direct Current Stimulation
Clinicians Warn Against DIY Transcranial Direct Current Stimulation

A group of clinicians have made a public plea to warn users of the dangers of do-it-yourself transcranial direct current stimulation (tDCS).

The authors of the editorial, published in Annals of Neurology, felt they had an “ethical obligation” to draw attention to the possible misuse of tDCS and the risks and complications associated with doing so.

“Scientific papers can give the impression that tDCS has clear benefits with no side effects, motivating do-it-yourself use. However the authors of these scientific papers generally do not encourage this. With do-it yourself tDCS on the rise, we thought it was time to outline why” author Michael D. Fox, MD, PhD, of Beth Israel Deaconess Medical Center and Massachusetts General Hospital in Boston, MA, said in a statement.

tDCS has been shown to be beneficial for the treatment of depression, anxiety, and other neurological conditions including multiple sclerosis and fibromyalgia. While some adverse events related to application site complications are well-characterized, other side effects may be less apparent.

The authors highlighted several areas of concern:

  • Stimulation can affect a greater area of the brain than intended due to current flow between electrodes, and therefore produce unintended alterations in brain function.
  • Activity before, during, and/or after may alter the effects of tDCS, possibly producing unintended alterations in brain function.
  • tDCS may improve cognitive function in one area at the cost of another, and these changes may not be realized until long after stimulation.
  • The frequency of tDCS application may have unintended results, as duration of changes in brain activity has not been thoroughly explored.
  • Changes to tDCS settings, including current amplitude, duration of stimulation, and placement of electrodes can alter the effects of tDCS.
  • The effects of tDCS are variable from person to person, and users should be aware that demographic and health-related factors can have a strong influence on the results of tDCS.
  • Treating neurological diseases vs enhancing brain function have a different risk/benefit ratio when accounting for frequency of tDCS application.
  • tDCS in children should be especially cautious, as there is a lack of scientific data in this population documenting the effects of tDCS on the developing nervous system.

“We encourage consideration of these issues and involvement of health care providers in making decisions regarding DIY brain stimulation,” the authors concluded.

Reference

Wurzman R, Hamilton RH, Pascual-Leone A, Fox MD. An open letter concerning do-it-yourself users of transcranial direct current stimulation. Ann Neurol. 2016; doi: 10.1002/ana.24689.

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