title: Low-Intensity Transcranial Current Stimulation in Psychiatry.
abstract: Neurostimulation is rapidly emerging as an important treatment modality for psychiatric disorders. One of the fastest-growing and least-regulated approaches to noninvasive therapeutic stimulation involves the application of weak electrical currents. Widespread enthusiasm for low-intensity transcranial electrical current stimulation (tCS) is reflected by the recent surge in direct-to-consumer device marketing, do-it-yourself enthusiasm, and an escalating number of clinical trials. In the wake of this rapid growth, clinicians may lack sufficient information about tCS to inform their clinical practices. Interpretation of tCS clinical trial data is aided by familiarity with basic neurophysiological principles, potential mechanisms of action of tCS, and the complicated regulatory history governing tCS devices. A growing literature includes randomized controlled trials of tCS for major depression, schizophrenia, cognitive disorders, and substance use disorders. The relative ease of use and abundant access to tCS may represent a broad-reaching and important advance for future mental health care. Evidence supports application of one type of tCS, transcranial direct current stimulation (tDCS), for major depression. However, tDCS devices do not have regulatory approval for treating medical disorders, evidence is largely inconclusive for other therapeutic areas, and their use is associated with some physical and psychiatric risks. One unexpected finding to arise from this review is that the use of cranial electrotherapy stimulation devices-the only category of tCS devices cleared for use in psychiatric disorders-is supported by low-quality evidence.
authors.affiliation: From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the Department of Cell Biology and Physiology, the Department of Neurology, and the Neuroscience Center, University of North Carolina at Chapel Hill; the Department of Psychiatry, University of Minnesota Medical School, Minneapolis, and the Geriatric Research Education and Clinical Center, Minneapolis VA Health Care System, Minneapolis, Minn.; the Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I.
authors.forename: Noah S
authors.initials: NS
authors.lastname: Philip
authors.affiliation: From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the Department of Cell Biology and Physiology, the Department of Neurology, and the Neuroscience Center, University of North Carolina at Chapel Hill; the Department of Psychiatry, University of Minnesota Medical School, Minneapolis, and the Geriatric Research Education and Clinical Center, Minneapolis VA Health Care System, Minneapolis, Minn.; the Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I.
authors.forename: Brent G
authors.initials: BG
authors.lastname: Nelson
authors.affiliation: From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the Department of Cell Biology and Physiology, the Department of Neurology, and the Neuroscience Center, University of North Carolina at Chapel Hill; the Department of Psychiatry, University of Minnesota Medical School, Minneapolis, and the Geriatric Research Education and Clinical Center, Minneapolis VA Health Care System, Minneapolis, Minn.; the Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I.
authors.forename: Flavio
authors.initials: F
authors.lastname: Frohlich
authors.affiliation: From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the Department of Cell Biology and Physiology, the Department of Neurology, and the Neuroscience Center, University of North Carolina at Chapel Hill; the Department of Psychiatry, University of Minnesota Medical School, Minneapolis, and the Geriatric Research Education and Clinical Center, Minneapolis VA Health Care System, Minneapolis, Minn.; the Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I.
authors.forename: Kelvin O
authors.initials: KO
authors.lastname: Lim
authors.affiliation: From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the Department of Cell Biology and Physiology, the Department of Neurology, and the Neuroscience Center, University of North Carolina at Chapel Hill; the Department of Psychiatry, University of Minnesota Medical School, Minneapolis, and the Geriatric Research Education and Clinical Center, Minneapolis VA Health Care System, Minneapolis, Minn.; the Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I.
authors.forename: Alik S
authors.initials: AS
authors.lastname: Widge
authors.affiliation: From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the Department of Cell Biology and Physiology, the Department of Neurology, and the Neuroscience Center, University of North Carolina at Chapel Hill; the Department of Psychiatry, University of Minnesota Medical School, Minneapolis, and the Geriatric Research Education and Clinical Center, Minneapolis VA Health Care System, Minneapolis, Minn.; the Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I.
authors.forename: Linda L
authors.initials: LL
authors.lastname: Carpenter
mesh_terms: D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D018795:Device Approval; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy; D012565:Schizophrenic Psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D065908:Transcranial Direct Current Stimulation / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome
keywords: Antidepressants; ECT; Transcranial Electrical Current Stimulation