Noninvasive brain stimulation and athletic performance: a critical narrative review

In light of recent advances in sports medicine and neurorehabilitation, non-invasive brain stimulation (NIBS)-including techniques such as transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (tES)-show potential for enhancing sports performance and supporting rehabilitation. For this narrative critical review, we synthesized evidence from studies in which trained athletes and healthy individuals performed sports-related tasks. These studies were identified through a structured search of PubMed, Web of Science, Scopus, and Google Scholar. The findings indicate that NIBS can modulate neural activity to improve motor learning, skill acquisition, muscle strength, endurance, attention, decision-making, emotional regulation, and brain network plasticity, with a notable potential to accelerate the mastery of sport-specific skills essential for competitive success. Nevertheless, heterogeneity in study designs and stimulation protocols, alongside unresolved ethical concerns regarding athlete autonomy and fairness, continue to limit widespread adoption. While NIBS holds considerable promise for both athletic performance optimization and rehabilitation, further research is needed to clarify its mechanisms of action, standardize protocols, and establish robust ethical guidelines to safeguard athlete safety and integrity and fair competition.