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Published on: June 17, 2013
Low-Intensity Transcranial Current Stimulation in Psychiatry
Noah S Philip1, Brent G Nelson1, Flavio Frohlich1
1From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the Department of Cell Biology and Physiology, the Department of Neurology, and the Neuroscience Center, University of North Carolina at Chapel Hill; the Department of Psychiatry, University of Minnesota Medical School, Minneapolis, and the Geriatric Research Education and Clinical Center, Minneapolis VA Health Care System, Minneapolis, Minn.; the Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I.
Low-intensity transcranial electrical current stimulation (tCS) is a rapidly growing, unregulated psychiatric treatment. While evidence supports transcranial direct current stimulation (tDCS) for depression, regulatory approval is lacking, and risks exist for other applications.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Devices
Background:
- Neurostimulation is an emerging psychiatric treatment.
- Low-intensity transcranial electrical current stimulation (tCS) is rapidly growing and minimally regulated.
- Direct-to-consumer devices, DIY enthusiasm, and clinical trials reflect tCS popularity.
Purpose of the Study:
- To inform clinicians about tCS for psychiatric disorders.
- To review neurophysiological principles, mechanisms, and regulatory history of tCS.
- To evaluate the evidence base for tCS in major depression, schizophrenia, cognitive, and substance use disorders.
Main Methods:
- Review of randomized controlled trials (RCTs) of tCS for psychiatric disorders.
- Analysis of neurophysiological principles and mechanisms of action.
- Examination of the regulatory landscape for tCS devices.
Main Results:
- Evidence supports transcranial direct current stimulation (tDCS) for major depression.
- tDCS devices lack regulatory approval for medical treatment.
- Evidence for tCS in other psychiatric areas is inconclusive, with associated risks.
- Cranial electrotherapy stimulation devices have low-quality evidence despite clearance for psychiatric use.
Conclusions:
- tCS offers potential for broad mental health care due to ease of use and accessibility.
- Clinicians need comprehensive information on tCS efficacy, risks, and regulation.
- Further research and regulatory clarity are essential for safe and effective tCS implementation.
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