Clinical research with transcranial direct current stimulation (tDCS): challenges and future directions. Brunoni, A. R., Nitsche, M. A., Bolognini, N., Bikson, M., Wagner, T., Merabet, L., Edwards, D. J., Valero-Cabre, A., Rotenberg, A., Pascual-Leone, A., Ferrucci, R., Priori, A., Boggio, P. S., & Fregni, F. Brain Stimulation, 5(3):175–195, July, 2012.
doi  abstract   bibtex   
BACKGROUND: Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity, direct current to cortical areas facilitating or inhibiting spontaneous neuronal activity. In the past 10 years, tDCS physiologic mechanisms of action have been intensively investigated giving support for the investigation of its applications in clinical neuropsychiatry and rehabilitation. However, new methodologic, ethical, and regulatory issues emerge when translating the findings of preclinical and phase I studies into phase II and III clinical studies. The aim of this comprehensive review is to discuss the key challenges of this process and possible methods to address them. METHODS: We convened a workgroup of researchers in the field to review, discuss, and provide updates and key challenges of tDCS use in clinical research. MAIN FINDINGS/DISCUSSION: We reviewed several basic and clinical studies in the field and identified potential limitations, taking into account the particularities of the technique. We review and discuss the findings into four topics: (1) mechanisms of action of tDCS, parameters of use and computer-based human brain modeling investigating electric current fields and magnitude induced by tDCS; (2) methodologic aspects related to the clinical research of tDCS as divided according to study phase (ie, preclinical, phase I, phase II, and phase III studies); (3) ethical and regulatory concerns; and (4) future directions regarding novel approaches, novel devices, and future studies involving tDCS. Finally, we propose some alternative methods to facilitate clinical research on tDCS.
@article{brunoni2012,
	title = {Clinical research with transcranial direct current stimulation ({tDCS}): challenges and future directions},
	volume = {5},
	issn = {1876-4754},
	shorttitle = {Clinical research with transcranial direct current stimulation ({tDCS})},
	doi = {10.1016/j.brs.2011.03.002},
	abstract = {BACKGROUND: Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity, direct current to cortical areas facilitating or inhibiting spontaneous neuronal activity. In the past 10 years, tDCS physiologic mechanisms of action have been intensively investigated giving support for the investigation of its applications in clinical neuropsychiatry and rehabilitation. However, new methodologic, ethical, and regulatory issues emerge when translating the findings of preclinical and phase I studies into phase II and III clinical studies. The aim of this comprehensive review is to discuss the key challenges of this process and possible methods to address them.
METHODS: We convened a workgroup of researchers in the field to review, discuss, and provide updates and key challenges of tDCS use in clinical research.
MAIN FINDINGS/DISCUSSION: We reviewed several basic and clinical studies in the field and identified potential limitations, taking into account the particularities of the technique. We review and discuss the findings into four topics: (1) mechanisms of action of tDCS, parameters of use and computer-based human brain modeling investigating electric current fields and magnitude induced by tDCS; (2) methodologic aspects related to the clinical research of tDCS as divided according to study phase (ie, preclinical, phase I, phase II, and phase III studies); (3) ethical and regulatory concerns; and (4) future directions regarding novel approaches, novel devices, and future studies involving tDCS. Finally, we propose some alternative methods to facilitate clinical research on tDCS.},
	language = {eng},
	number = {3},
	journal = {Brain Stimulation},
	author = {Brunoni, Andre Russowsky and Nitsche, Michael A. and Bolognini, Nadia and Bikson, Marom and Wagner, Tim and Merabet, Lotfi and Edwards, Dylan J. and Valero-Cabre, Antoni and Rotenberg, Alexander and Pascual-Leone, Alvaro and Ferrucci, Roberta and Priori, Alberto and Boggio, Paulo Sergio and Fregni, Felipe},
	month = jul,
	year = {2012},
	pmid = {22037126},
	pmcid = {PMC3270156},
	keywords = {Brain, Humans, Animals, Forecasting, Biomedical Research, Brain Diseases, Transcranial Magnetic Stimulation},
	pages = {175--195},
	file = {Accepted Version:/Users/lcneuro/Zotero/storage/9542WHD5/Brunoni et al. - 2012 - Clinical research with transcranial direct current.pdf:application/pdf},
}

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