Difference between revisions of "Transcranial direct-current stimulation"

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The lack of information, is another issue which is connected with the sale of tDCS devices. Especially, the devices which are sold as DIY kits (e.g. [[Go Flow Pro]], [[TDCS-KIT]], [[TDCS Device Kit]], [[TDCS Transcranial Stimulation Kit]]) tends to avoid any claim which could lead to FDA concerns. These concerns led to the denial of [[GoFlow]] project and it ceased the sale of [[TDCS Device Kit]].<ref name=" A pragmatic analysis"/> Jwa points out that the members of DIY tDCS community regulates those who tent to make dangerous mistakes and advice them on their fora<ref name="Early adopters"/> and Wexler argues that these community is acquainted with the research.<ref>WEXLER, Anna. The practices of do-it-yourself brain stimulation: implications for ethical considerations and regulatory proposals. Journal of Medical Ethics [online]. 2015, Aug 31. Doi: 10.1136/medethics-2015-102704 Available online at: http://jme.bmj.com/content/early/2015/08/30/medethics-2015-102704.abstract (Retrieved 18th November, 2016).</ref> However, the devices could be purchased by any customers, even those who are not involved in DIY tDCS community. Therefore, the appropriate amount of information about the devices is needed.<ref name="neuroethics"/> COHEN KADOSH, Roi et al. The neuroethics of non-invasive brain stimulation. Current Biology [online]. 2012, Feb 21. Doi: 10.1016/j.cub.2012.01.013 Available online at: http://dx.doi.org/10.1016/j.cub.2012.01.013 (Retrieved 7th December, 2016).</ref>
 
The lack of information, is another issue which is connected with the sale of tDCS devices. Especially, the devices which are sold as DIY kits (e.g. [[Go Flow Pro]], [[TDCS-KIT]], [[TDCS Device Kit]], [[TDCS Transcranial Stimulation Kit]]) tends to avoid any claim which could lead to FDA concerns. These concerns led to the denial of [[GoFlow]] project and it ceased the sale of [[TDCS Device Kit]].<ref name=" A pragmatic analysis"/> Jwa points out that the members of DIY tDCS community regulates those who tent to make dangerous mistakes and advice them on their fora<ref name="Early adopters"/> and Wexler argues that these community is acquainted with the research.<ref>WEXLER, Anna. The practices of do-it-yourself brain stimulation: implications for ethical considerations and regulatory proposals. Journal of Medical Ethics [online]. 2015, Aug 31. Doi: 10.1136/medethics-2015-102704 Available online at: http://jme.bmj.com/content/early/2015/08/30/medethics-2015-102704.abstract (Retrieved 18th November, 2016).</ref> However, the devices could be purchased by any customers, even those who are not involved in DIY tDCS community. Therefore, the appropriate amount of information about the devices is needed.<ref name="neuroethics"/> COHEN KADOSH, Roi et al. The neuroethics of non-invasive brain stimulation. Current Biology [online]. 2012, Feb 21. Doi: 10.1016/j.cub.2012.01.013 Available online at: http://dx.doi.org/10.1016/j.cub.2012.01.013 (Retrieved 7th December, 2016).</ref>
  
−
The use of tDCS in childhood is another ethical issue. As was mentioned previously the manufacturers of tDCS devices usually claim that their device should not been use by people under 18. There are, however, certain research which focuses on enhancement and treatment through tDCS.(reference). Roi Cohen Kadosh and his colleagues point out several ethical questions with regards to the use of tDCS in a childhood. Namely, they ask, if we should allow parents to let their children to enhance one skill at the cost of another skill. Moreover, if tDCS prove to be efficient and safe even for children, they ask if parents have obligation to treat their children with tDCS.<ref name="neuroethics"/>
+
The use of tDCS in childhood is another ethical issue. As was mentioned previously the manufacturers of tDCS devices usually claim that their device should not been use by people under 18. There are, however, certain research which focuses on treatment through tDCS.<ref> For instance: SCHNEIDER Harry D., HOPP Jenna P. The use of the Bilingual Aphasia Test for assessment and transcranial direct current stimulation to modulate language acquisition in minimally verbal children with autism. Clinical Linguistics & Phonetics [online]. 2011, Jun 1. Doi: 10.3109/02699206.2011.570852 Available online at: http://dx.doi.org/10.3109/02699206.2011.570852 (Retrieved 7th December, 2016).</ref> Roi Cohen Kadosh and his colleagues point out several ethical questions with regards to the use of tDCS in a childhood. Namely, they ask, if we should allow parents to let their children to enhance one skill at the cost of another skill. Moreover, if tDCS prove to be efficient and safe even for children, they ask if parents have obligation to treat their children with tDCS.<ref name="neuroethics"/>
  
 
The relative availability and ease-of-use of tDCS, with the assumption that the effects on cognition are indeed present, raise questions about it being used as a form of 'cheating' or otherwise gaining unfair advantage over non-users. A study on tDCS on athletes resulted in the subjects having better muscle endurance and decreased muscle fatigue.<ref>COGIAMANIAN, F., MARCEGLIA, S., ARDOLINO, G., BARBIERI, S. and PRIORI, A. Improved isometric force endurance after transcranial direct current stimulation over the human motor cortical areas. European Journal of Neuroscience. 2007, '''26'''(1), p. 242–249. Doi: 10.1111/j.1460-9568.2007.05633.x.</ref> While this is beneficial for treatment of fatigue, it also raises concerns whether this could be used in healthy sportsmen as a form of doping that is undetectable by chemical tests. WADA(the World Anti-Doping Agency) and the International Olympic Committee are aware of this issue. At the moment they investigate, if tDCS is really efficient. If there is scientific proof that tDCS enhance sport performance of athletes, WADA will consider tDCS to be doping, when it will shows that it harms health of athletes or violate "the spirit of sport."<ref>STRICKLAND, Eliza. Olympic Athletes Are Electrifying Their Brains, and You Can Too. IEEE Spectrum [online]. 2016, Aug 23. Available online at: http://spectrum.ieee.org/biomedical/bionics/olympic-athletes-are-electrifying-their-brains-and-you-can-too (Retrieved 12th September, 2016).</ref>  
 
The relative availability and ease-of-use of tDCS, with the assumption that the effects on cognition are indeed present, raise questions about it being used as a form of 'cheating' or otherwise gaining unfair advantage over non-users. A study on tDCS on athletes resulted in the subjects having better muscle endurance and decreased muscle fatigue.<ref>COGIAMANIAN, F., MARCEGLIA, S., ARDOLINO, G., BARBIERI, S. and PRIORI, A. Improved isometric force endurance after transcranial direct current stimulation over the human motor cortical areas. European Journal of Neuroscience. 2007, '''26'''(1), p. 242–249. Doi: 10.1111/j.1460-9568.2007.05633.x.</ref> While this is beneficial for treatment of fatigue, it also raises concerns whether this could be used in healthy sportsmen as a form of doping that is undetectable by chemical tests. WADA(the World Anti-Doping Agency) and the International Olympic Committee are aware of this issue. At the moment they investigate, if tDCS is really efficient. If there is scientific proof that tDCS enhance sport performance of athletes, WADA will consider tDCS to be doping, when it will shows that it harms health of athletes or violate "the spirit of sport."<ref>STRICKLAND, Eliza. Olympic Athletes Are Electrifying Their Brains, and You Can Too. IEEE Spectrum [online]. 2016, Aug 23. Available online at: http://spectrum.ieee.org/biomedical/bionics/olympic-athletes-are-electrifying-their-brains-and-you-can-too (Retrieved 12th September, 2016).</ref>  

Revision as of 14:07, 7 December 2016

Various models of tDCS devices

List of Transcranial direct-current stimulation:

Transcranial direct-current stimulation, tDCS in short, is a neoromodulatory technique in which a small and constant direct current is delivered through the skull in order to inhibit or excite neurons in the brain, that is to say to change the threshold at which the neurons will fire. Therefore it can not directly create new neural activity, but influence the existing activity.[1] tDCS may help patients suffering from strong depression and it may also relieve pain, help patients with neurodegenerative diseases, or enhance human cognition.[2]

It is possible, however, that tDCS have no effect on the actual cognitive performance as it has been found by a quantitative review of past tDCS studies in 2015.[3]

Main characteristics

The tDCS is done by putting two electrodes on the scalp and running weak direct current between them so the current passes through the brain. Different areas of the brain can be affected based on the position of the electrodes. Depending on whether the stimulation is anodal or cathodal, the neuronal resting membrane potential is either depolarized or hyperpolarized respectively. Anodal stimulation enhances excitability, while cathodal stimulation has opposite results. The efficacy of the technique closely depends on the strenght of the generated electrical field. Clinically, tDCS is usually administered via two sponge electrodes soaked in a saline solution for conductibility.[4][5]

The effects of tDCS can be long-lasting. Prolonged sessions result in after-effects that may last hours. This is due to the brain neurotransmitters and receptors having polar properties and as such they react to electrical fields which results in lasting neurochemical changes in the brain. tDCS has a lasting effect on NMDA receptors and intracortical and corticospinal neurons. This type of stimulation also influences non-neuronal components of the nervous system, such as vessels and connective tissues, and can influence the widening of the blood vessels in the brain.[2]

Historical overview

A schematics showing how tDCS works.

The ability of the electrical current to influence human cognition, especially the perception of pain, has been observer since the 48 CE by the Roman court physician Scribonius Largus. He observed that placing a live fish of the order Torpediniformes, able to deliver electric discharge of up to 220 V, can ease the pain of the headaches his patients suffered. Other great physicians such as Pliny the Elder, Claudius Galen, or Ibn-Sidah noted the beneficial effects of these animals in their works as well. The study of electric rays inspired Luigi Galvani and Alessandro Volta to experiment with the effects of electrical current on human physiology.[6] Galvani’s nephew Giovanni Aldini reported the successful treatment of patients suffering from melancholia.[7] He noted, after testing his device on himself first, that the stimulation is rather unpleasant and it's effects lasted for several days:

"First, the fluid took over a large part of my brain, which felt a strong shock, a sort of jolt against the inner surface of my skull. The effect increased further as I moved the electric arcs from one ear to the other. I felt a strong head stroke and I became insomniac for several days." - Giovanni Aldini, 1803[8]

Experiments with the DC stimulation continued until the 1930' when its usage was abandoned in favour of more reliable electroconvulsive therapy which, for a while, overshadowed the practice of brain polarization and later by the advances in pharmaceutics. However, the research into the effects of DC did not cease. In 1964, Joe Redfearn stimulated volunteers with tDCS. He reported that the participants became more 'giggly'. Then he treated also patients with depression. However the results were not conclusive, mainly due to use of low current. The method was rehabilitated recently by Michael Nitsche and Alberto Priori[9][6][10] tDCS is also getting popular among the 'hacker' communities, such as reddit's /r/tDCS,[11] or DIY tDCS [12] since they are able to build the devices themselves.

Purpose

Transcranial direct-current stimulation is a tool used to treat neuropsychiatric diseases and to influence human cognition without the use of invasive methods or pharmaceutics.[13]

Important Dates

  • 1st century CE - Roman physician Scribonius Largus helps patients with headaches by placing electric rays over their heads.
  • 18th century - Galvani and Volta experiment with the effects of electric current on human physiology and the brain.
  • 1930' - tDCS is largely abandoned in favour of electroconvulsive therapy.
  • 1964 - Joe Redfearn was conducted research on tDCS.
  • 2000' - Priori and Nietsche's experiments introduced a new era of tDCS research.[9]

Enhancement/Therapy/Treatment

Position of electrodes in accordance with International system

There were several experiments, which suggested that tDCS could enhance certain abilities and that it could be used as a treatment of various diseases.[14] In contrast, the experiments conducted by Theresa Iuculano and Roi Cohen Kadosh point out that the enhancement of certain abilities could lead to impairment of other abilities.[15] The efficiency of tDCS was also doubted by certain researchers e.g.[16]

The effect of tDCS method is based on neuroplasticity, which is brain's ability to change. Kue et al argue in their paper that tDCS could reverse pathological changes of brain which are responsible for various neuropsychiatric diseases. They specifically mention a treatment of pain, tinnitus, depression, addiction, schizophrenia, anxiety disorder and dementia.[17] In addition, Agnes Flöel, who listed several research concerning tDCS, claims that tDCS treatment could have positive impact to patients who suffers from mild cognitive impairment, Alzheimer's disease, movement disorders, epilepsy, or persistent deficits after stroke.[14]

Anita Jwa points out various fields of cognitive enhancement, which could be provided by tDCS. Namely, tDCS is supposed to improve language learning, numerical learning or performance in video games.[18] Recently, there have been also suggested that tDCS could enhance sport performance due to improvement of motor learning.[19]

Ethical & Health Issues

Although tDCS is non-invasive treatment and is deemed to be safe, there arose several ethical issues. They are linked with the use of tDCS devices in general, with the do-it-yourself community and also with a specific use and setting of certain devices.

The developers of tDCS devices usually point out certain conditions to which it is nor recommended to use tDCS devices. It is primarily the age under 18, since the brain still develops in the youth. Another limits are history of seizures, epilepsy, pregnancy, brain lesions, bipolar depression, or severe heart disease. The patients with implant should also avoid a use of tDCS devices, since they could negatively interfere with their implant. In addition, the session should not exceed certain amount of time (usually 30 minutes) and there should be a certain gap between each session.[20]

The precise effect the direct current has on the brain itself is still not deeply understood. There is a possibility that long-term usage may be harmful and that some unwanted after-effects will occur. However, with observation of the proper experimentation protocol, especially the need to have a constant current density,[21] tDCS stimulation is deemed not to be harmful. More studies, however, have to be conducted to claim this conclusively.

The great deal of issues, which is linked with tDCS devices, rise from the DIY community. tDCS devices were originally used only in laboratory research, but the compelling results made certain tech enthusiasts to create their own tDCS devices. Besides, the components of tDCS devices are relatively cheap and the construction of these devices is not difficult.[22] These practice alarmed the researchers who published in Annals of Neurology an open letter with various concerns concerning tDCS devices, primarily those used outside of laboratories. They point out that there are several issues which could influence an output of the session and could lead to unintended effects. Firstly, electrodes usually extends the regions which should be stimulated, thus the current could influence more regions. Secondly, the stimulation is influenced by the bulk of personal features and activities which precedes and follows after it. Thirdly, the enhancement of one skill could be accompanied with the impairment of other skill. Fourthly, even a small change in the session, could lead to completely different output of the session. Finally, the brain and the physical features of each person is more or less different. The excitability of the brain or position of brain centres variates among population. Factors as handedness, gender or a different head anatomy could influence the output of the session. In addition, they argue that these potential risks are still acceptable in the case of a treatment but it is doubtful if they are worth the enhancement.[23]

The lack of information, is another issue which is connected with the sale of tDCS devices. Especially, the devices which are sold as DIY kits (e.g. Go Flow Pro, TDCS-KIT, TDCS Device Kit, TDCS Transcranial Stimulation Kit) tends to avoid any claim which could lead to FDA concerns. These concerns led to the denial of GoFlow project and it ceased the sale of TDCS Device Kit.[22] Jwa points out that the members of DIY tDCS community regulates those who tent to make dangerous mistakes and advice them on their fora[18] and Wexler argues that these community is acquainted with the research.[24] However, the devices could be purchased by any customers, even those who are not involved in DIY tDCS community. Therefore, the appropriate amount of information about the devices is needed.[25] COHEN KADOSH, Roi et al. The neuroethics of non-invasive brain stimulation. Current Biology [online]. 2012, Feb 21. Doi: 10.1016/j.cub.2012.01.013 Available online at: http://dx.doi.org/10.1016/j.cub.2012.01.013 (Retrieved 7th December, 2016).</ref>

The use of tDCS in childhood is another ethical issue. As was mentioned previously the manufacturers of tDCS devices usually claim that their device should not been use by people under 18. There are, however, certain research which focuses on treatment through tDCS.[26] Roi Cohen Kadosh and his colleagues point out several ethical questions with regards to the use of tDCS in a childhood. Namely, they ask, if we should allow parents to let their children to enhance one skill at the cost of another skill. Moreover, if tDCS prove to be efficient and safe even for children, they ask if parents have obligation to treat their children with tDCS.[25]

The relative availability and ease-of-use of tDCS, with the assumption that the effects on cognition are indeed present, raise questions about it being used as a form of 'cheating' or otherwise gaining unfair advantage over non-users. A study on tDCS on athletes resulted in the subjects having better muscle endurance and decreased muscle fatigue.[27] While this is beneficial for treatment of fatigue, it also raises concerns whether this could be used in healthy sportsmen as a form of doping that is undetectable by chemical tests. WADA(the World Anti-Doping Agency) and the International Olympic Committee are aware of this issue. At the moment they investigate, if tDCS is really efficient. If there is scientific proof that tDCS enhance sport performance of athletes, WADA will consider tDCS to be doping, when it will shows that it harms health of athletes or violate "the spirit of sport."[28]

Anita Jwa, who conducted research among DIY tDCS community, claims that 56 out of 121 responding users declared an experience of certain side effects. These are headache, discomforting feeling under electrodes, fatigue, nervousness or mood change, concentration difficulties, sleeping disturbance, change of visual perception or nausea.[18]

Public & Media Impact and Presentation

With the 'brain hacking' community growing, tDCS techniques also got the attention of the media. Elif Batuman describes her experience with tDCS. She underwent stimulation in several sessions. She writes that the stimulation had some unpleasant but temporal effects on her skin and cognitive abilities, but that it was successful in treating her depression she usually takes medication for.[29] An article in The Huffington Post written by an former NASA engineers also calls tDCS brain-hacking. He explains that he feels that 'brain hacking' is essential to making human lives better.[30] Another article on TechCrunch, written by Daniel Chao, the CEO of Halo Neuroscience, talks about

Brain stimulation is especially popular among young, more tech-savvy adults. The community holds regular meetups and discussions, for example the Consiousness Hacking Meetup[31] on which the enthusiasts share their experience and on which entrepreneurs introduce their brain stimulation products.

http://www.newyorker.com/business/currency/an-evening-with-the-consciousness-hackers

http://techcrunch.com/2016/03/18/your-optimized-brain-exploring-the-frontier-of-neurostimulation/

http://www.washingtonpost.com/sf/national/2016/03/03/brain-hacking-hot-wired-for-happiness/

http://motherboard.vice.com/read/the-science-and-snake-oil-of-neurostimulation?trk_source=homepage-lede

http://www.nature.com/nature/journal/v531/n7592_supp/full/531S6a.html

Public Policy

Related Technologies, Projects or Scientific Research

https://thebrainstimulator.net/research/

http://www.consciousnesshacking.org/about/

http://eu.foc.us/

https://www.haloneuro.com/

References

  1. ↑ http://www.newyorker.com/magazine/2015/04/06/electrified
  2. ↑ 2.0 2.1 BRUNONI, Andre Russowsky, et al. Clinical research with transcranial direct current stimulation (tDCS): challenges and future directions. Brain stimulation, 2012, 5.3: 175-195.
  3. ↑ HORVATH, Jared Cooney, FORTE, Jason D. and CARTER, Olivia. Quantitative review finds no evidence of cognitive effects in healthy populations from single-session transcranial direct current stimulation (tDCS). Brain Stimulation [online]. 2015. 8(3), p. 535–550. Doi: 10.1016/j.brs.2015.01.400. Available online at: http://dx.doi.org/10.1016/j.brs.2015.01.400
  4. ↑ NITSCHE, M. A.; PAULUS, W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. The Journal of physiology, 2000, 527.3: 633-639.
  5. ↑ A., Antal, Paulus W. a Nitsche M.A., 2009. Principle and mechanisms of transcranial Direct Current Stimulation (tDCS). Journal of Pain Management [online]. roč. 2, č. 3, s. 249–257. Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed9&NEWS=N&AN=2010453470
  6. ↑ 6.0 6.1 PRIORI, Alberto. Brain polarization in humans: A reappraisal of an old tool for prolonged non-invasive modulation of brain excitability. Clinical Neurophysiology. 2003. 114(4), p. 589–595. Doi: 10.1016/S1388-2457(02)00437-6.
  7. ↑ PARENT, André. Giovanni Aldini: from animal electricity to human brain stimulation. The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques. 2004. 31(4), p. 576–584. Doi: 10.1017/S0317167100003851.
  8. ↑ ALDINI, G. Précis des expériences galvaniques faites récemment à Londres et à Calais par Jean Aldini […], suivi d’un extrait d’autres expériences, détaillées dans un ouvrage du même auteur, et qui ont été publiées à Londres par M. Nicholson. Paris: Levrault et Barrau, 1803.
  9. ↑ 9.0 9.1 FOX, Douglas. Neuroscience: Brain buzz. Nature [online]. 2011, Apr 13. Doi: 10.1038/472156a Available online at: http://www.nature.com/news/2011/110413/full/472156a.html (Retrieved 5th December, 2016).
  10. ↑ NITSCHE, Michael A., COHEN, Leonardo G., WASSERMANN, Eric M., PRIORI, Alberto, LANG, Nicolas, ANTAL, Andrea, PAULUS, Walter, HUMMEL, Friedhelm, BOGGIO, Paulo S., FREGNI, Felipe a PASCUAL-LEONE, Alvaro, Transcranial direct current stimulation: State of the art 2008. Brain Stimulation. 2008. 1(3), p. 206–223. Doi: 10.1016/j.brs.2008.06.004.
  11. ↑ https://www.reddit.com/r/tDCS
  12. ↑ DIY tDCS [online]. Available online at: http://www.diytdcs.com/ (Retrieved 5th December, 2016).
  13. ↑ ANTAL, A., PAULUS W., NIETSCHE M.A. Principle and mechanisms of transcranial Direct Current Stimulation (tDCS). Journal of Pain Management. 2009. 2(3), 249–257. Available online at: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed9&NEWS=N&AN=2010453470 (Retreived 7th December, 2016).
  14. ↑ 14.0 14.1 FLÖEL, Agnes. tDCS-enhanced motor and cognitive function in neurological diseases. NeuroImage [online]. 2013, May 30. Doi: 10.1016/j.neuroimage.2013.05.098 Available online at: http://www.sciencedirect.com/science/article/pii/S1053811913006009 (Retrieved 6th December, 2016).
  15. ↑ IUCULANO, Theresa; COHEN KADOSH, Roi. The Mental Cost of Cognitive Enhancement. J Neurosci 10 [online]. 2013, Mar 6. Available online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672974/ (Retrieved 1st November, 2016).
  16. ↑ HORVATH, Jared Cooney et al. Quantitative Review Finds No Evidence of Cognitive Effects in Healthy Populations From Single-session Transcranial Direct Current Stimulation (tDCS). Brain Stimulation [online]. 2015, Jan 16. Doi: http://dx.doi.org/10.1016/j.brs.2015.01.400. Available online at: http://www.brainstimjrnl.com/article/S1935-861X(15)00857-8/abstract (Retrieved 10th November, 2016).
  17. ↑ KUO, Min-Fang et al. Therapeutic effects of non-invasive brain stimulation with direct currents (tDCS) in neuropsychiatric diseases. NeuroImage [online]. 2013, Jun 4. Doi: 10.1016/j.neuroimage.2013.05.117 Available online at: http://www.sciencedirect.com/science/article/pii/S1053811913006277 (Retrieved 6th December, 2016).
  18. ↑ 18.0 18.1 18.2 JWA, Anita. Early adopters of the magical thinking cap: a study on do-it-yourself (DIY) transcranial direct current stimulation (tDCS) user community. Journal of Law and the Biosciences [online]. 2015, Jun 2. Doi: 10.1093/jlb/lsv017 Available online at: http://jlb.oxfordjournals.org/content/early/2015/06/01/jlb.lsv017.full.pdf+html (Retrieved 22nd November, 2016).
  19. ↑ ZHU, Frank P. et al. Cathodal Transcranial Direct Current Stimulation Over Left Dorsolateral Prefrontal Cortex Area Promotes Implicit Motor Learning in a Golf Putting Task. Brain Stimulation [online]. 2015, Mar 14. Doi: 10.1016/j.brs.2015.02.005 Available online at: http://www.sciencedirect.com/science/article/pii/S1935861X15008852 (Retrieved 16th November, 2016).
  20. ↑ Foc.us. Focus Go Flow Manual & Instruction Booklet. Foc.us [online]. Available online at: http://help.foc.us//article/38-focus-go-flow-manual-instruction-booklet (Retrieved 28th November, 2016).
  21. ↑ NITSCHE, Michael, LIEBETANZ, David, LANG, Nicolas, ANTAL, Andrea, TERGAU, Frithjof, PAULUS, Walter and PRIORI, Alberto. Safety criteria for transcranial direct current stimulation (tDCS) in humans [1] (multiple letters). Clinical Neurophysiology. 2003, 114(11), p. 2220–2223. Doi: 10.1016/S1388-2457(03)00235-9.
  22. ↑ 22.0 22.1 WEXLER, Anna. A pragmatic analysis of the regulation of consumer transcranial direct current stimulation (TDCS) devices in the United States. Journal of Law and the Biosciences [online]. 2015, Oct 12. Available online at: http://jlb.oxfordjournals.org/content/2/3/669.full.pdf+html (Retrieved 1st November, 2016).
  23. ↑ WURZMAN, Rachel et al. An open letter concerning do-it-yourself users of transcranial direct current stimulation. Annals of Neurology [online]. 2016, Jul 7. Doi: 10.1002/ana.24689 Available online at: http://onlinelibrary.wiley.com/doi/10.1002/ana.24689/abstract (Retrieved 16th November, 2016).
  24. ↑ WEXLER, Anna. The practices of do-it-yourself brain stimulation: implications for ethical considerations and regulatory proposals. Journal of Medical Ethics [online]. 2015, Aug 31. Doi: 10.1136/medethics-2015-102704 Available online at: http://jme.bmj.com/content/early/2015/08/30/medethics-2015-102704.abstract (Retrieved 18th November, 2016).
  25. ↑ 25.0 25.1 Cite error: Invalid <ref> tag; no text was provided for refs named neuroethics
  26. ↑ For instance: SCHNEIDER Harry D., HOPP Jenna P. The use of the Bilingual Aphasia Test for assessment and transcranial direct current stimulation to modulate language acquisition in minimally verbal children with autism. Clinical Linguistics & Phonetics [online]. 2011, Jun 1. Doi: 10.3109/02699206.2011.570852 Available online at: http://dx.doi.org/10.3109/02699206.2011.570852 (Retrieved 7th December, 2016).
  27. ↑ COGIAMANIAN, F., MARCEGLIA, S., ARDOLINO, G., BARBIERI, S. and PRIORI, A. Improved isometric force endurance after transcranial direct current stimulation over the human motor cortical areas. European Journal of Neuroscience. 2007, 26(1), p. 242–249. Doi: 10.1111/j.1460-9568.2007.05633.x.
  28. ↑ STRICKLAND, Eliza. Olympic Athletes Are Electrifying Their Brains, and You Can Too. IEEE Spectrum [online]. 2016, Aug 23. Available online at: http://spectrum.ieee.org/biomedical/bionics/olympic-athletes-are-electrifying-their-brains-and-you-can-too (Retrieved 12th September, 2016).
  29. ↑ http://www.newyorker.com/magazine/2015/04/06/electrified
  30. ↑ http://www.huffingtonpost.com/turnstyle/silicon-valleys-next-big_b_6793910.html
  31. ↑ http://www.consciousnesshacking.org/
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