DEBATE REPORT

TRANSCRANIAL CURRENT STIMULATION IS A RELIABLE TREATMENT

METHOD FOR BRAIN DISORDERS
(AGAINST THE TOPIC)

Team 9 (Members):
Abhishek Kumar (210039)
Jahnvi Singh (210460)
Khushi Kanchan (210516)
Shreya Yadav (211004)
Snehamol Sukumar (211045)
Yash Kumar Dromar (211191)

WHAT IS TRANSCRANIAL CURRENT STIMULATION (TCS)?

Transcranial current stimulation (TCS) is a non-invasive brain stimulation technique
which aims to modulate the neural activities in the brain by delivering low amplitude
current that is usually less than 2 mA over a short period of time, between the electrodes.
The fundamental goal of TCS approach is to alter brain connection and activity, which
may result in modifications to cognitive or neurological processes. Researchers and
medical professionals are looking into the use of TCS for many different things, such as
improving cognitive function, controlling pain, regulating mood, and treating several
neurological and psychiatric illnesses like depression, schizophrenia, and chronic pain.
Direct current (tDCS), alternating current (tACS), random noise (tRNS), and pulsed
current (tPCS) stimulations are the four primary transcranial paradigms of transcranial
current stimulation.
Transcranial Direct Current Stimulation (tDCS) is the most widely researched method for
treating brain disorders. There are over 1200 tDCS publications, with more than 200
being clinical trials for multiple clinical disorders. In tDCS, saline soaked sponges act as
anode and cathode which are connected via wires to the battery terminals. It is believed
that the brain area beneath the anode experiences depolarization, while the region beneath
the cathode may undergo hyperpolarization.

EFFICIENCY AND RELIABILITY OF TRANSCRANIAL CURRENT

STIMULATION FOR THE TREATMENT OF BRAIN DISORDERS
• The efficiency of tDCS varies depending on factors such as individual's age and
gender.
• The shape of the skull is different for different individuals. There is also a
difference in skull thickness, cerebrospinal fluid volume, neuroplasticity and
volume of white and gray matter in every individual. Hence it is not a necessity
that it works in the same way for everyone.
• This method cannot be considered reliable as it has not been approved by the Food
and Drugs Administration (FDA) due to a lack of research. Further research with
positive results and reassuring safety data are needed before tDCS gets approval
from regulators.
• In cases of self-application, unintended consequences like impairment of cognitive
function due to reversal of the two electrodes can occur.
• Due to the small number of studies and the high heterogeneity of the data, more
high-quality studies using standardized parameters and measures are needed
before tDCS can be considered as a treatment for different brain disorders.
• The results of the experiments regarding substance craving and drug seeking were
not definitive.
• There is a lack of research in the applicability of improvement of dementia,
traumatic brain injury and Parkinson’s disease.

SIDE EFFECTS AND CONSEQUENCES OF USING TRANSCRANIAL

CURRENT STIMULATION
• The most reported side effects include itching, tingling, headache, insomnia,
nausea, burning sensation, and discomfort. These are similar in adults and
children. The physical adverse effects are restricted to the site of stimulation. The
possible occurrence of skin lesions under the electrode placement sites following
stimulation is another area of concern, for instance, lesions due to increased skin
temperature may be observed.
 • In a study conducted by Lippold and Redfearn it was observed that while
delivering current to healthy subjects via bifrontal electrodes with reference on the
leg, they encountered one case of respiratory and motor paralysis with cramping of
the hands, accompanied by nausea.
• In another study conducted by Flavio Frohlich a PhD study senior author and
assistant professor of psychiatry, the participants were divided into two groups and
were judged on the basis of an IQ test for perceptual reasoning. Perceptual
reasoning is associated with fluid intelligence, which is defined as the ability to
think logically and apply innovative problem solving to new problems. One group
received sham stimulation while the other received active tDCS. They noticed that
the scores for perceptual reasoning were much lower in the group that underwent
active tDCS.

LIMITATIONS
Transcranial current stimulation studies cannot be performed on the following
patients:
- Patients with brain implants
- Patients with history of brain tumor, epilepsy and brain surgery.
- Patients who use pacemakers
- Patients with unstable medical condition.

Children have a developing brain. There are more physiological differences in

their brains as compared to mature individuals. These physiological differences
may result in different levels of excitability in the brain of each child. This can
have an unsafe effect, specifically seizures which is a serious adverse event due to
which it is difficult to conduct research on children.

ALTERNATIVES FOR TRANSCRANIAL CURRENT STIMULATION

• Escitalopram a Selective Serotonin Reuptake Inhibitor (SSRI) can be
considered a better alternative to TCS. As stated by the literature, tDCS did
not show superiority for the treatment of depression over a 10-week period.
 In a trial, tDCS was associated with adverse side effects. Infact there was a
significant reduction in the HDRS-17(Hamilton Depression Rating Scale-17)
scores of the participants as compared to that of the participants undergoing
active tDCS. Two of the patients had onset of mania during the conduct of
trial but no such effect was observed with escitalopram.
• Transcranial Magnetic Stimulation (TMS) is also a better alternative as it
has been investigated thoroughly as clinical trials have been performed for
different brain diseases. It is found to be more focal and targeted than TCS
as it makes use of magnetic fields.

CONCLUSION
There is an uncertainty as there are no large or long-term studies on TCS. Apparently,
there is some neural machinery involved in the cognitive functions. This machinery is not
changed by the use of TCS and thus does not bring a difference in the performance of
those cognitive functions. There are many limitations and sources of errors while
conducting trials of TCS which make it a less reliable method of treating brain disorders.

REFERENCES
[1] Popular electric brain stimulation method used to boost brainpower is detrimental to
IQ scores

[2] Transcranial direct current stimulation (tDCS) of frontal cortex decreases

performance on the WAIS-IV intelligence test

[3] Using transcranial direct-current stimulation (tDCS) to understand cognitive

processing
[4] Can electrical brain stimulation boost attention, memory, and more?
[5]Trial of Electrical Direct-Current Therapy versus Escitalopram for Depression.
[6] No effect of transcranial direct current stimulation of the dorsolateral prefrontal cortex
on short‐term memory

[7] Change in core symptoms of borderline personality disorder by tDCS: A pilot study
[8] Tenets of transcranial direct current stimulation
[9] Role of Transcranial Direct Current Stimulation in the Management of Alzheimer’s
Disease: A Meta-analysis of Effects, Adherence and Adverse Effects
[10] Transcranial Direct Current Stimulation in Treatment of Child
Neuropsychiatric Disorders: Ethical Considerations