Evidence map›Paper›PMID 32710772›Full record

SynthesisThe international journal of neuropsychopharmacology2021

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

Felipe Fregni, Mirret M El-Hagrassy, Kevin Pacheco-Barrios, Sandra Carvalho, Jorge Leite, Marcel Simis, Jerome Brunelin, Ester Miyuki Nakamura-Palacios, Paola Marangolo, Ganesan Venkatasubramanian and 5 more

5 registry-linked trialsOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The international journal of neuropsychopharmacology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 291 papers, 18 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
291citing papers in PubMed, 18 pooled it
25.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

NCT04780152 phase2 / phase3unknown statusnot on this map

Assessment of Efficacy and Safety of Anodal Transcranial Direct Current Stimulation (TDCS) in Pediatric and Teenage Patients With Major Depressive Disorder During COVID-19 Pandemics

TypeinterventionalSponsorEl Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco SuarezRan2021 to 2022Enrolled172ConditionsMajor Depressive DisorderArmsTranscranial Direct Current Stimulation, Placebo-simulation of transcranial direct current stimulation, Fluoxetine Tablets
NCT05269953 nacompletednot on this mapstarted 2022, after this paper: background citation

A Randomised, Double-blind, Placebo-controlled, Trial of Rhythmic 10Hz Median Nerve Stimulation for the Suppression of the Urge-to-tic and Reduction of Tics in Individuals With Tourette Syndrome and Chronic Tic Disorder

TypeinterventionalSponsorNottingham University Hospitals NHS TrustRan2022 to 2023Enrolled135ConditionsTourette Syndrome, Chronic Tic DisorderArmsActive stimulation, Sham stimulation
NCT06640634 nacompletednot on this mapstarted 2022, after this paper: background citation

Effect of Anodal Transcranial Direct Current Stimulation on Postdural Puncture Headache: Results of Two Randomized Sham - Controlled Trials

TypeinterventionalSponsorNeuromed IRCCSRan2022 to 2024Enrolled97ConditionsPostdural Puncture Headache, Lumbar PunctureArmsactive in therapeutic tDCS (Th-tDCS): anodal transcranial Direct Current Stimulation (a-tDCS), sham in therapeutic tDCS (Th-tDCS): anodal transcranial Direct Current Stimulation (a-tDCS), active in preventive tDCS (Pr-tDCS): anodal transcranial Direct Current Stimulation (a-tDCS), sham in preventive tDCS (Pr-tDCS): anodal transcranial Direct Current Stimulation (a-tDCS)
NCT07203339 narecruitingnot on this mapstarted 2025, after this paper: background citation

Home-based Transcranial Direct Current Stimulation (tDCS) Compared to Duloxetine in the Treatment of Fibromyalgia: a Randomized Non-inferiority Clinical Trial (FIBROSTIM)

TypeinterventionalSponsorHospital de Clinicas de Porto AlegreRan2025 to 2028Enrolled610ConditionsFibromyalgia (FM), tDCS, Duloxetine, BDNFArmsTranscranial direct current stimulation (tDCS) plus placebo., Duloxetine (60 mg) once daily, Home-based transcranial direct current stimulation, Duloxetine 60 mg
NCT07237165 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Evaluation of the Analgesic Effect of Direct Current Stimulation in the Treatment of Pelvic Pain, Comparing Three Groups: Trans-spinal Stimulation, Ganglionic Stimulation, and Placebo. A Randomized Double-blind Study

TypeinterventionalSponsorUniversity Hospital, GrenobleRan2025 to 2029Enrolled60ConditionsChronic Pelvic PainArmsNon-invasive device-based neuromodulation
3 · Its place in the literature

Who cites it

291 citing papers in PubMed, 18 syntheses or guidelines pooled it, 572 citations in OpenAlex.

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  5. Efficacy of Transcranial Direct Current Stimulation in Patients with Primary Progressive Aphasia: A Systematic Review and Updated Meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
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231 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 13 institutions in 8 countries.

Felipe FregniNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Massachusetts.
Mirret M El-HagrassyNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Massachusetts.
Kevin Pacheco-BarriosNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Massachusetts.
Sandra CarvalhoNeurotherapeutics and experimental Psychopathology Group (NEP), Psychological Neuroscience Laboratory, CIPsi, School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal.
Jorge LeiteI2P-Portucalense Institute for Psychology, Universidade Portucalense, Porto, Portugal.
Marcel SimisPhysical and Rehabilitation Medicine Institute of the University of Sao Paulo Medical School General Hospital, Sao Paulo, Brazil.
Jerome BrunelinCH Le Vinatier, PSYR2 team, Lyon Neuroscience Research Center, UCB Lyon 1, Bron, France.
Ester Miyuki Nakamura-PalaciosLaboratory of Cognitive Sciences and Neuropsychopharmacology, Department of Physiological Sciences, Federal University of Espírito Santo, Espírito Santo, Brasil (Dr Nakamura-Palacios).
Paola MarangoloDipartimento di Studi Umanistici, Università Federico II, Naples, Italy.
Ganesan VenkatasubramanianTranslational Psychiatry Laboratory, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
Daniel San-JuanNeurophysiology Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico.
Wolnei CaumoPost-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS) Surgery Department, School of Medicine, UFRGS; Pain and Palliative Care Service at Hospital de Clínicas de Porto Alegre (HCPA) Laboratory of Pain and Neuromodulation at HCPA, Porto Alegre, Brazil.
Marom BiksonDepartment of Biomedical Engineering, The City College of New York of CUNY, New York, New York.
André R BrunoniService of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry & Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Neuromodulation Center Working Group
Spaulding Rehabilitation Hospital · USCity College of New York · USHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo · BRHospital São Paulo · BRInstituto Nacional de Neurología y Neurocirugía · MXIstituti di Ricovero e Cura a Carattere Scientifico · ITMassachusetts General Hospital · USNational Institute of Mental Health and Neurosciences · INUniversidade Federal do Espírito Santo · BRUniversidade Federal do Rio Grande do Sul · BRUniversidade Portucalense · PTUniversité Claude Bernard Lyon 1 · FRUniversity of Minho · PT

Funding

Pragmatic Trial of Remote tDCS and Somatosensory Training for Phantom Limb Pain with Machine Learning to Predict Treatment ResponseR01HD082302 · NICHD · SPAULDING REHABILITATION HOSPITAL · PI Felipe Fregni · 2015 to 2026
$4.7M
Optimized tDCS for fibromyalgia: targeting the endogenous pain control systemR01AT009491 · NCCIH · SPAULDING REHABILITATION HOSPITAL · PI FREGNI, FELIPE · 2018 to 2023
$2.3M
NCCIH NIH HHS R01 AT009491NICHD NIH HHS R01 HD082302
6 · The paper itself

Abstract

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

objectiveWe 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.

methodsExperts 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.

resultsAlthough 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).

conclusionAll 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.

Indexed as

Brain DiseasesEvidence-Based MedicineHumansMental DisordersPainPractice Guidelines as TopicTranscranial Direct Current Stimulationclinical evidenceevidence-based medicineneurological disorderspsychiatric disorderstDCS

Identifiers

PMID32710772
PMCPMC8059493
OpenAlexW3044497410

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.