Lefaucheur, Jean-Pascal and Antal, Andrea and Ayache, Samar S. and Benninger, David H. and Brunelin, Jerome and Cogiamanian, Filippo and Cotelli, Maria and De Ridder, Dirk and Ferrucci, Roberta and Langguth, Berthold and Marangolo, Paola and Mylius, Veit and Nitsche, Michael A. and Padberg, Frank and Palm, Ulrich and Poulet, Emmanuel and Priori, Alberto and Rossi, Simone and Schecklmann, Martin and Vanneste, Sven and Ziemann, Ulf and Garcia-Larrea, Luis and Paulus, Walter (2017) Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). CLINICAL NEUROPHYSIOLOGY, 128 (1). pp. 56-92. ISSN 1388-2457, 1872-8952
Full text not available from this repository. (Request a copy)Abstract
A group of European experts was commissioned by the European Chapter of the International Federation of Clinical Neurophysiology to gather knowledge about the state of the art of the therapeutic use of transcranial direct current stimulation (tDCS) from studies published up until September 2016, regarding pain, Parkinson's disease, other movement disorders, motor stroke, poststroke aphasia, multiple sclerosis, epilepsy, consciousness disorders, Alzheimer's disease, tinnitus, depression, schizophrenia, and craving/addiction. The evidence-based analysis included only studies based on repeated tDCS sessions with sham tDCS control procedure; 25 patients or more having received active treatment was required for Class I, while a lower number of 10-24 patients was accepted for Class II studies. Current evidence does not allow making any recommendation of Level A (definite efficacy) for any indication. Level B recommendation (probable efficacy) is proposed for: (i) anodal tDCS of the left primary motor cortex (M1) (with right orbitofrontal cathode) in fibromyalgia; (ii) anodal tDCS of the left dorsolateral prefrontal cortex (DLPFC) (with right orbitofrontal cathode) in major depressive episode without drug resistance; (iii) anodal tDCS of the right DLPFC (with left DLPFC cathode) in addiction/craving. Level C recommendation (possible efficacy) is proposed for anodal tDCS of the left M1 (or contralateral to pain side, with right orbitofrontal cathode) in chronic lower limb neuropathic pain secondary to spinal cord lesion. Conversely, Level B recommendation (probable inefficacy) is conferred on the absence of clinical effects of: (i) anodal tDCS of the left temporal cortex (with right orbitofrontal cathode) in tinnitus; (ii) anodal tDCS of the left DLPFC (with right orbitofrontal cathode) in drug-resistant major depressive episode. It remains to be clarified whether the probable or possible therapeutic effects of tDCS are clinically meaningful and how to optimally perform tDCS in a therapeutic setting. In addition, the easy management and low cost of tDCS devices allow at home use by the patient, but this might raise ethical and legal concerns with regard to potential misuse or overuse. We must be careful to avoid inappropriate applications of this technique by ensuring rigorous training of the professionals and education of the patients. (C) 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | NONINVASIVE BRAIN-STIMULATION; RANDOMIZED-CONTROLLED-TRIAL; DORSOLATERAL PREFRONTAL CORTEX; HUMAN MOTOR CORTEX; SPINAL-CORD-INJURY; RANDOM NOISE STIMULATION; PROOF-OF-CONCEPT; ALTERNATING-CURRENT STIMULATION; MAJOR DEPRESSIVE DISORDER; ELECTRICAL-CURRENT THERAPY; Cortex; Indication; Neurological disease; Neuromodulation; Noninvasive brain stimulation; Psychiatric disease; tDCS; Treatment |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Psychiatrie und Psychotherapie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2018 12:58 |
| Last Modified: | 14 Feb 2019 09:29 |
| URI: | https://pred.uni-regensburg.de/id/eprint/99 |
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