tDCS- TRANSCRANIAL DIRECT CURRENT STIMULATION

WHAT IS tDCS – TRANSCRANIAL DIRECT CURRENT STIMULATION?

tDCS – transcranial direct current stimulation, is a brain neuromodulation technique that applies a galvanic current at low intensity to the scalp (transcranial) with the aim of stimulating specific areas of the brain.

Transcranial electrical stimulation is applied by placing different electrodes on the skull depending on the cortical areas to be stimulated in each case and applying a galvanic current (constant) through these electrodes.

During stimulation there is an alteration of the membrane potential of the neuron depending on its polarity.

  1. tDCS anode

Neuronal soma Depolarisation.
Apical dendrite Hyperpolarised.

tDCS estimulación anodica


High effectiveness

  1. tDCS cathodic:

Neuronal soma Hyperpolarised.
Apical dendrite Depolarisation.

tDCS estimulación transcraneal por corriente directa catodica

 High effectiveness

Fuente: Hamada et al. 2013; Wiethoff et al. 2014

In short, the application of tDCS produces a neuromodulatory effect on neuronal excitability and favours the neuroplasticitybrain, in the brain area of application, and therefore the reorganisation of its neuronal connections, requiring the application of several sessions on a regular basis, favouring the clinical improvement of multiple pathologies such as those described below.

The application of transcranial direct current stimulation must be by means of a device with a health certificate for this intended use such as a EPTE® Bipolar System

BENEFITS OF tDCS – TRANSCRANIAL DIRECT CURRENT STIMULATION

The application of transcranial direct current stimulation (tDCS) is non-invasive and painless. The introduction of this technique in clinical practice allows it to be combined with other techniques, such as percutaneous neuromodulation, percutaneous electrolysis, therapeutic exercise, etc…, allowing the enhancement of these techniques, speeding up recovery times and reducing the consumption of drugs.

The correct application of tDCS requires prior training in order to know the specific protocols for each type of pathology, as well as the applicable current doses, desired parameters, safety aspects in the application of the technique such as maximum current density, adverse effects and contraindications.

tDCS APPLICATION – TRANSCRANIAL DIRECT CURRENT STIMULATION

The application of tDCS has a great deal of scientific evidence, its origin being in the field of psychiatry and psychology, and in recent years the evidence in the field of pain and motor disorders has positioned it as a technique applicable in the physiotherapy sector.

The fields of application of this technique are:

  • Chronic neuropathic pain.
  • Chronic pain
  • Motor disorders caused by neurological injuries such as those resulting from cerebrovascular accidents (stroke) or others.
  • Motor rehabilitation (neuromotor learning).
  • Migraines
  • Attention
  • Depression
  • Anxiety
  • Addictions

There is a non-medical area of application, which is Fibromyalgia.

(1) The use of tDCS therapy in patients with fibromyalgia is defined as non-medical use because fibromyalgia is not considered internationally as a pathology in its own right, but rather as a syndrome. Due to the positive effects on the symptoms associated with fibromyalgia that have been obtained in different studies, it is considered a non-medical application.

ADVERSE EFFECTS

Los efectos adversos de aplicación de esta técnica son leves, siendo:

  • Itching.
  • Tingling.
  • Headache (transitorio).
  • Burning sensation.
  • Discomfort.

NOT RECOMMENDED in the following cases

  • Patients with defibrillators.
  • Patients with pacemakers.
  • Patients with brain stimulators.
  • Patients with implanted intracranial metals.
  • Patients with open skull, after trepanation.
  • Damaged skin or recent scars.
  • Paediatric patients (under 14 years of age).
  • Pregnant women.

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