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Remotely Supervised Transcranial Direct Current Stimulation: An Update on Safety and Tolerability

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Published on: October 7, 2017

Objective electrophysiological fatigability markers and their modulation through tDCS.

Stefanie Linnhoff¹, Janika Wolter-Weging¹, Tino Zaehle²

¹Department of Neurology, Otto-von-Guericke-University Magdeburg, Leipziger Street 44, Magdeburg 39120, Germany.

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology

|April 19, 2021

Summary

Cognitive fatigability can now be objectively measured using electrophysiological markers. Transcranial direct current stimulation (tDCS) shows promise in treating fatigability, especially in neuropsychiatric conditions.

Keywords:

Cognitive fatigue Fatigability Objective measurement Prepulse inhibition Sensory gating tDCS

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Last Updated: Nov 8, 2025

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Area of Science:

Neuroscience
Cognitive Science
Clinical Neurophysiology

Background:

Cognitive fatigability is a common symptom impacting daily function and is prevalent in neuropsychiatric disorders.
Current diagnosis relies heavily on subjective fatigue reports, lacking objective measures.
There is a need for objective assessment tools and effective interventions for cognitive fatigability.

Purpose of the Study:

To establish objective electrophysiological parameters for assessing cognitive fatigability.
To investigate the therapeutic potential of transcranial direct current stimulation (tDCS) in mitigating cognitive fatigability.

Main Methods:

A pseudo-randomized, sham-controlled trial involving 40 healthy participants.
Participants underwent an exhaustive cognitive task to induce fatigability.
Electrophysiological measures including prepulse inhibition (PPI), P50 suppression, frontomedial theta, and occipital alpha power were analyzed.

Main Results:

The cognitive task successfully induced subjective exhaustion and objective fatigability markers.
Fatigability increased frontomedial theta and occipital alpha power, while reducing PPI and P50 sensory gating.
Anodal tDCS over the left dorsolateral prefrontal cortex (DLPFC) counteracted these fatigability effects.

Conclusions:

Occipital alpha power and sensory gating serve as reliable objective measures of cognitive fatigability.
Anodal tDCS demonstrates therapeutic potential for managing cognitive fatigability, particularly in neuropsychiatric contexts.