Evidence-Based Guidelines and Secondary Meta-Analysis for the Use of Transcranial Direct Current Stimulation in Neurological and Psychiatric Disorders

 Evidence-Based Guidelines and Secondary Meta-Analysis for the Use of Transcranial Direct Current Stimulation in Neurological and Psychiatric Disorders

Abstract

Background

Transcranial direct current stimulation has shown promising clinical results, leading to increased demand for an evidence-based review on its clinical effects.

Objective

We convened a team of transcranial direct current stimulation experts to conduct a systematic review of clinical trials with more than 1 session of stimulation testing: pain, Parkinson’s disease motor function and cognition, stroke motor function and language, epilepsy, major depressive disorder, obsessive compulsive disorder, Tourette syndrome, schizophrenia, and drug addiction.

Methods

Experts were asked to conduct this systematic review according to the search methodology from PRISMA guidelines. Recommendations on efficacy were categorized into Levels A (definitely effective), B (probably effective), C (possibly effective), or no recommendation. We assessed risk of bias for all included studies to confirm whether results were driven by potentially biased studies.

Results

Although most of the clinical trials have been designed as proof-of-concept trials, some of the indications analyzed in this review can be considered as definitely effective (Level A), such as depression, and probably effective (Level B), such as neuropathic pain, fibromyalgia, migraine, post-operative patient-controlled analgesia and pain, Parkinson’s disease (motor and cognition), stroke (motor), epilepsy, schizophrenia, and alcohol addiction. Assessment of bias showed that most of the studies had low risk of biases, and sensitivity analysis for bias did not change these results. Effect sizes vary from 0.01 to 0.70 and were significant in about 8 conditions, with the largest effect size being in postoperative acute pain and smaller in stroke motor recovery (nonsignificant when combined with robotic therapy).

Conclusion

All recommendations listed here are based on current published PubMed-indexed data. Despite high levels of evidence in some conditions, it must be underscored that effect sizes and duration of effects are often limited; thus, real clinical impact needs to be further determined with different study designs.

Full article here

What is Transcranial Direct Current Stimulation

 

The basics of transcranial Direct Current Stimulation (tDCS):

Transcranial Direct-Current Stimulation (tDCS) is a portable, wearable brain stimulation technique that delivers a low electric current to the scalp. A fixed current between 1 and 2 mA is typically applied1. tDCS works by applying a positive (anodal) or negative (cathodal) current via electrodes to an area. tDCS is a neuromodulation technique that produces immediate and lasting changes in brain function. The position of the anode and cathode electrodes on the head is used to set how current flows to specific brain regions. The current delivered by tDCS is NOT strong enough to trigger an action potential in a neuron; instead its “sub-threshold” ..... 

MORE HERE

"tACDC" - Blended Transcranial Electrical Stimulation for Childhood Autism & ADHD : Evaluation of Procedural Feasibility

 

"tACDC" - Blended Transcranial Electrical Stimulation 

for Childhood Autism & ADHD : Evaluation of Procedural Feasibility"

Poster presentation at the International Brain Stimulation Conference 2025

Kobe, Japan

Alexandria Elkhadem - 1; Joshua Rotenberg, MD - 1

1-Houston Specialty Clinic

TDCS for Depression - Better than sham

Efficacy and acceptability of transcranial direct current stimulation (tDCS) for major depressive disorder: An individual patient data meta-analysis

Article Abstract

More literature HERE

https://www.ncbi.nlm.nih.gov/sites/myncbi/103bGJGeIgzQv/collections/59242511/public/

Transcranial Electrical Stimulation (tES) using TDCS for ADHD and Autism

We are excited to introduce a new complementary treatment option available at our clinic, Transcranial Electrical Stimulation (tES).

 TES using direct current stimulation (TDCS) has shown promising results for individuals with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).

Transcranial Electrical Stimulation is a non-invasive procedure that involves the application of a low-intensity electrical current to the scalp. This current is thought to influence brain activity and has been studied for its potential benefits in various neurological and psychiatric conditions.

For individuals with ASD, tES has been explored as a way to enhance cognitive abilities and address core pathologies of autism. Studies have suggested that tES could improve mini-columnar morphology and gamma oscillations in the brain, which are areas that can be atypical in individuals with ASD 1.

In the case of ADHD, tES, particularly transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex, has been investigated for its ability to improve cognitive control and impulse regulation. This could lead to significant improvements in cognition and impulse control for those with ADHD 2.

It’s important to note that while tES has very few potential side effects, it is an emerging therapeutic tool. It is still considered complementary for ASD and ADHD, meaning it is not meant to replace standard treatments. 

Does tES hurt? In studies, subjects rated the discomfort as between watching TV and going to the dentist.

Our clinic is committed to providing the latest and most effective treatments, and the data indicates that tES offers a new avenue for improving the quality of life for our patients with ASD and ADHD.

If you or a loved one are interested in exploring this treatment option, we invite you to schedule a consultation. 

Who is not a candidate? 

• Consider if they can sit still and tolerate mild discomfort for 30 minutes? If not, this treatment may not be the right fit. 
• Skull defects and transcranial metal surgical implants may preclude this treatment. 

During this consultation, we will discuss the potential benefits, the procedure, and any questions you may have.

Your health and well-being are our top priority, and we are here to support you.

To learn more check our website link here. Please do not hesitate to reach out to us for more information or to arrange an appointment.

Ask about other uses:

• Traumatic brain injury
• Stroke
• Multiple sclerosis
• Movement disorders
• Memory difficulties
• Headaches
• Major depressive disorder
• Schizophrenia
• Craving in substance use disorders
• Obsessive-compulsive disorder
• Mild cognitive impairment

New Home Sleep Apnea test for Children and Adults

 What is the SleepImage Ring (SIR) ? 

The SIR is a simple, comfortable device that adult and pediatric patients can wear on their finger overnight. It has been cleared by the FDA for the diagnosis and management of sleep-disordered breathing, including obstructive sleep apnea (OSA) and central sleep apnea (CSA).

Here are some of the key benefits of this testing :

Ease of Use: The ring is designed to be worn on any finger, ensuring a snug fit without discomfort. This user-friendly approach allows for a more natural sleep study experience 1.

Comprehensive Data Collection: During sleep, the ring streams raw physiological data to a mobile app, which then uploads the data for analysis. This process provides extensive data that is interpreted by our specialists 1.

FDA-Cleared for Children and Adults: The SleepImage system is suitable for use in children over the age of 2 and adults 1.

In-Home Convenience: Patients to conduct sleep studies in their natural sleeping environment,  reducing the likelihood of an overnight stay in a sleep clinic. By reducing the stress associated with traditional sleep studies, more patients can be screened 2.

Tracking Treatment Progress: The SIR helps in monitoring the effectiveness of treatments 3.

Cost-Effective: With the SIR, we offer patients a cost-effective alternative to traditional polysomnography4.

Why are the kids waiting for sleep studies and EEG? Why are they paying so much?

Subject: Why are the kids waiting for sleep studies and EEG? Why are they paying so much?

Dear Referring Physicians and Health Care Professionals, 

I hope this message finds you well. I am writing to (re)-introduce you to Academy Diagnostics’ sleep & EEG diagnostics services. Our commitment to excellence and to personal care sets us apart. We are proud to carry the gold-standard AASM (American Academy of Sleep Medicine) accreditation for over 10 years. 

Our Services: 

1. Pediatric Sleep Studies and Adult Sleep Studies: Our state-of-the-art facility is equipped to perform comprehensive sleep studies for children of all ages. From infants to adolescents, we tailor our assessments to meet the unique needs of pediatric patients. 

2. EEG Testing: We offer advanced EEG monitoring services, aiding in the diagnosis and management of various neurological conditions. 

Why Choose Academy Diagnostics? 

• Expertise: Our team of board-certified pediatric sleep specialists and neurologists has extensive experience. 

• Child-Friendly Environment: We understand the importance of creating a comfortable and reassuring atmosphere for young patients. 

• Timely Reporting: Prompt turnaround time for test results ensures timely intervention and treatment planning. 

• 360 Sleep Medicine Care: A sleep center is more than a testing facility, it includes access to board certified sleep medicine specialists to support a comprehensive care plan. 

Openings for Studies: We currently have openings for studies in the next 1-2 months. If you have patients who may benefit from a prompt study, you may refer them today. 

To schedule a direct sleep study or EEG, please contact Academy at 832-210-2405 or visit the Academy website at https://www.academysleepcenter.com 

Thank you for entrusting your patients’ care to Academy Diagnostics. We look forward to improving the health and well-being of our young patients. 

Sincerely, 

Josh Rotenberg MD, Pediatric Neurology & Epilepsy 

Sarat Susarla MD, Pediatric Pulmonology 

www.houstonspecialtyclinic.com