ArticleBrain stimulation
Adaptive current tDCS up to 4 mA.
Article in Brain stimulation. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 66 citations in OpenAlex.
- Non-invasive brain stimulation for improving gait, balance, and lower limbs motor function in stroke.Journal of neuroengineering and rehabilitation · 2022Pooled it
- Optimized multichannel 4 mA vs conventional transcranial direct current stimulation for major depressive disorder: A randomized sham-controlled trial.Molecular psychiatry · 2026Trial
- Increased leg muscle fatigability during 2 mA and 4 mA transcranial direct current stimulation over the left motor cortex.Experimental brain research · 2020Trial
- Robust enhancement of motor sequence learning with 4 mA transcranial electric stimulation.Brain stimulationTrial
- 2 mA is NOT 2 mA: Electric field variability in high-definition tDCS and its implications for precision neuromodulation in aging.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2026Article
- The inconsistent effects of tDCS in rehabilitation and cognitive enhancement: sources of variability and paths to personalization.Frontiers in human neuroscience · 2026Review
- Noninvasive Neurostimulation to the Inferior Frontal Sulcus or Cerebellum Improves Accuracy But Not Timing in a Speech Motor Learning Task.Neurobiology of language (Cambridge, Mass.) · 2025Article
- Dose-response of tDCS effects on motor learning and cortical excitability: A preregistered study.Imaging neuroscience (Cambridge, Mass.) · 2025Article
- Research progress on transcranial direct current stimulation for improving muscle strength: a narrative review.Frontiers in neurology · 2025Review
- Article
- Personalized Dose Selection for Treatment of Patients with Neuropsychiatric Disorders Using tDCS.Brain sciences · 2024Article
- Leveraging Artificial Intelligence to Optimize Transcranial Direct Current Stimulation for Long COVID Management: A Forward-Looking Perspective.Brain sciences · 2024Article
- Closed-Loop Transcranial Electrical Neurostimulation for Sustained Attention Enhancement: A Pilot Study towards Personalized Intervention Strategies.Bioengineering (Basel, Switzerland) · 2024Article
- Neuromodulation on the ground and in the clouds: a mini review of transcranial direct current stimulation for altering performance in interactive driving and flight simulators.Frontiers in psychology · 2024Review
- Lack of effects of online HD-tDCS over the left or right DLPFC in an associative memory and metamemory monitoring task.PloS one · 2024Article
- Lattice layout and optimizer effect analysis for generating optimal transcranial electrical stimulation (tES) montages through the metaheuristic L1L1 method.Frontiers in human neuroscience · 2024Article
- Evaluation of tolerability and safety of transcranial electrical stimulation with gel particle electrodes in healthy subjects.Frontiers in psychiatry · 2024Article
- The Effects of Transcranial Direct Current Stimulation in Patients with Mild Cognitive Impairment.Neurology international · 2023Review
- Repeated Anodal Transcranial Direct Current Stimulation (RA-tDCS) over the Left Frontal Lobe Increases Bilateral Hippocampal Cell Proliferation in Young Adult but Not Middle-Aged Female Mice.International journal of molecular sciences · 2023Article
- Transcranial Direct Current Stimulation for Chronic Stroke: Is Neuroimaging the Answer to the Next Leap Forward?Journal of clinical medicine · 2023Review
Corrections and comments
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
backgroundHigher tDCS current may putatively enhance efficacy, with tolerability the perceived limiting factor.
objectiveWe designed and validated electrodes and an adaptive controller to provide tDCS up to 4 mA, while managing tolerability. The adaptive 4 mA controller included incremental ramp up, impedance-based current limits, and a Relax-mode where current is transiently decreased. Relax-mode was automatically activated by self-report VAS-pain score >5 and in some conditions by a Relax-button available to participants.
methodsIn a parallel-group participant-blind design with 50 healthy subjects, we used specialized electrodes to administer 3 daily session of tDCS for 11 min, with a lexical decision task as a distractor, in 5 study conditions: adaptive 4 mA, adaptive 4 mA with Relax-button, adaptive 4 mA with historical-Relax-button, 2 mA, and sham. A tablet-based stimulator with a participant interface regularly queried VAS pain score and also limited current based on impedance and tolerability. An Abort-button provided in all conditions stopped stimulation. In the adaptive 4 mA with Relax-button and adaptive 4 mA with historical-Relax-button conditions, participants could trigger a Relax-mode ad libitum, in the latter case with incrementally longer current reductions. Primary outcome was the average current delivered during each session, VAS pain score, and adverse event questionnaires. Current delivered was analyzed either excluding or including dropouts who activated Abort (scored as 0 current).
resultsThere were two dropouts each in the adaptive 4 mA and sham conditions. Resistance based current attenuation was rarely activated, with few automatic VAS pain score triggered relax-modes. In conditions with Relax-button option, there were significant activations often irrespective of VAS pain score. Including dropouts, current across conditions were significantly different from each other with maximum current delivered during adaptive 4 mA with Relax-button. Excluding dropouts, maximum current was delivered with adaptive 4 mA. VAS pain score and adverse events for the sham was only significantly lower than the adaptive 4 mA with Relax-button and adaptive 4 mA with historical-Relax-button. There was no difference in VAS pain score or adverse events between 2 mA and adaptive 4 mA.
conclusionsProvided specific electrodes and controllers, adaptive 4 mA tDCS is tolerated and effectively blinded, with acceptability likely higher in a clinical population and absence of regular querying. Indeed, presenting participants with overt controls increases rumination on sensation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.