Evidence map›Paper›PMID 41219988›Full record

ReviewNeurological research and practice2025

What are the optimal transcranial direct current stimulation parameters and design elements to modulate corticospinal excitability? A systematic review and longitudinal meta-analysis.

Liam C Tapsell, Matheus D Pinto, Ann-Maree Vallence, Casey Whife, Maria Luciana Perez Armendariz, Shaswat Senger, Jack Andringa-Bate, Dana Hince, Myles C Murphy

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Neurological research and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Article
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

9 authors.

Liam C TapsellNutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
Matheus D PintoNutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
Ann-Maree VallenceSchool of Psychology, College of Health and Education, Murdoch University, Murdoch, WA, Australia.
Casey WhifeNutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
Maria Luciana Perez ArmendarizNutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
Shaswat SengerMedical School, University of Western Australia, Crawley, WA, Australia.
Jack Andringa-BateLa Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, Australia.
Dana HinceInstitute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia.
Myles C MurphyNutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia. m.murphy@ecu.edu.au.ORCID http://orcid.org/0000-0001-6068-1096

Funding

Department of Health, Government of Western Australia IF2022-23/5Raine Medical Research Foundation RPG035-2023
6 · The paper itself

Abstract

backgroundCorticospinal excitability, measured by motor-evoked potentials (MEPs), is often impaired in neurological and musculoskeletal conditions. Transcranial direct current stimulation (tDCS) can modulate cortical excitability and improve clinical outcomes, yet inconsistencies in parameter settings complicate identification of optimal protocols.

objectiveOur primary objective was to examine the effects of: (i) stimulation polarity, (ii) duration, (iii) intensity, (iv) frequency, (v) electrode montage, and (vi) electrode design (size/shape) on MEP size.

methodsNine databases were searched from inception to 24th November 2023. We identified 84 individual cohorts (1,709 participants) and assessed time-dependent effects of each parameter on M1 MEP-to-baseline ratio in healthy and clinical populations using multi-level longitudinal meta-analysis.

resultsAnodal tDCS increased MEP size, with effects lasting up to 120 min post-stimulation. Consistent effects were observed with anodal tDCS durations ≥ 20 min and intensities ≥ 1.5 mA. Despite cohorts being matched, cathodal tDCS reduced MEP size for approximately 15 min post-stimulation, with significant effects at durations ≥ 9 min, intensity effects were inconclusive. Electrode montage and electrode size/shape influenced MEP, with greatest effect for electrodes over both the primary motor cortex and the dorsolateral pre-frontal cortex or over the cerebellar region, using 4 cm

conclusiontDCS effects on corticospinal excitability are parameter dependent. Anodal tDCS tends to facilitate excitability, whereas cathodal tDCS tends to inhibit excitability (depending on stimulation parameters). Specific durations, intensities, electrode placements and designs will ensure effectiveness and optimise safety. Findings support a parameter-specific approach to guide tailored neuromodulation interventions to enhance motor cortex rehabilitation outcomes.

Indexed as

Cortical excitabilityElectrical brain stimulationFacilitationInhibitionMotor cortexNeural plasticityStimulation parameterstDCS

Identifiers

PMID41219988
PMCPMC12606828

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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.