Sham tDCS: A hidden source of variability? Reflections for further blinded, controlled trials

  • Clara Fonteneau
    Affiliations
    INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, F-69000, France

    University Lyon 1, Villeurbanne, F-69000, France

    Centre Hospitalier Le Vinatier, Lyon, F-69000, France
    Search for articles by this author
  • Marine Mondino
    Affiliations
    INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, F-69000, France

    University Lyon 1, Villeurbanne, F-69000, France

    Centre Hospitalier Le Vinatier, Lyon, F-69000, France
    Search for articles by this author
  • Martijn Arns
    Affiliations
    neuroCare Group GmbH, Munich, Germany

    Research Institute Brainclinics, Nijmegen, the Netherlands
    Search for articles by this author
  • Chris Baeken
    Affiliations
    Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium

    Department of Psychiatry, University Hospital UZBrussel, Brussels, Belgium

    Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium
    Search for articles by this author
  • Marom Bikson
    Affiliations
    Department of Biomedical Engineering, The City College of New York, New York City, NY, USA
    Search for articles by this author
  • Andre R. Brunoni
    Affiliations
    Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany

    Service of Interdisciplinary Neuromodulation (SIN), Laboratory of Neuroscience (LIM27) and National Institute of Biomarkers in Neuropsychiatry (INBioN), Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
    Search for articles by this author
  • Matthew J. Burke
    Affiliations
    Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
    Search for articles by this author
  • Tuomas Neuvonen
    Affiliations
    Sooma Oy, Kuortaneenkatu 2, 00510, Helsinki, Finland
    Search for articles by this author
  • Frank Padberg
    Affiliations
    Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany
    Search for articles by this author
  • Alvaro Pascual-Leone
    Affiliations
    Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
    Search for articles by this author
  • Emmanuel Poulet
    Affiliations
    INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, F-69000, France

    University Lyon 1, Villeurbanne, F-69000, France

    Centre Hospitalier Le Vinatier, Lyon, F-69000, France
    Search for articles by this author
  • Giulio Ruffini
    Affiliations
    Neuroelectrics Corporation, 210 Broadway, 02139, Cambridge, MA, USA
    Search for articles by this author
  • Emiliano Santarnecchi
    Affiliations
    Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
    Search for articles by this author
  • Anne Sauvaget
    Affiliations
    CHU de Nantes, Psychiatric Neuromodulation Unit, Addictology and Liaison-Psychiatry Department, Nantes, France

    Laboratory “Movement, Interactions, Performance” (E.A. 4334), Faculty of Sport Sciences, University of Nantes, Nantes, France
    Search for articles by this author
  • Klaus Schellhorn
    Affiliations
    neuroCare Group GmbH, Munich, Germany
    Search for articles by this author
  • Marie-Françoise Suaud-Chagny
    Affiliations
    INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, F-69000, France

    University Lyon 1, Villeurbanne, F-69000, France

    Centre Hospitalier Le Vinatier, Lyon, F-69000, France
    Search for articles by this author
  • Ulrich Palm
    Affiliations
    Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany
    Search for articles by this author
  • Jérome Brunelin
    Correspondence
    Corresponding author. Centre Hospitalier Le Vinatier, Equipe de Recherche PSYR2 - CRNL, Pôle Est - Bâtiment 416, 1er étage, BP 300 39 – 95 boulevard Pinel, 69678, Bron Cedex, France.
    Affiliations
    INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, F-69000, France

    University Lyon 1, Villeurbanne, F-69000, France

    Centre Hospitalier Le Vinatier, Lyon, F-69000, France
    Search for articles by this author
Published:January 02, 2019DOI:https://doi.org/10.1016/j.brs.2018.12.977

      Abstract

      Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique increasingly used to modulate neural activity in the living brain. In order to establish the neurophysiological, cognitive or clinical effects of tDCS, most studies compare the effects of active tDCS to those observed with a sham tDCS intervention. In most cases, sham tDCS consists in delivering an active stimulation for a few seconds to mimic the sensations observed with active tDCS and keep participants blind to the intervention. However, to date, sham-controlled tDCS studies yield inconsistent results, which might arise in part from sham inconsistencies. Indeed, a multiplicity of sham stimulation protocols is being used in the tDCS research field and might have different biological effects beyond the intended transient sensations. Here, we seek to enlighten the scientific community to this possible confounding factor in order to increase reproducibility of neurophysiological, cognitive and clinical tDCS studies.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and PersonalCorporate R&D Professionals
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      References

        • Brunoni A.R.
        • Amadera J.
        • Berbel B.
        • Volz M.S.
        • Rizzerio B.G.
        • Fregni F.
        A systematic review on reporting and assessment of adverse effects associated with transcranial direct current stimulation.
        Int J Neuropsychopharmacol. 2011; 14: 1133-1145https://doi.org/10.1017/S1461145710001690
        • Woods A.J.
        • Antal A.
        • Bikson M.
        • Boggio P.S.
        • Brunoni A.R.
        • Celnik P.
        • et al.
        A technical guide to tDCS, and related non-invasive brain stimulation tools.
        Clin Neurophysiol. 2016; 127: 1031-1048https://doi.org/10.1016/j.clinph.2015.11.012
        • Bikson M.
        • Brunoni A.R.
        • Charvet L.E.
        • Clark V.P.
        • Cohen L.G.
        • Deng Z.-D.
        • et al.
        Rigor and reproducibility in research with transcranial electrical stimulation: an NIMH-sponsored workshop.
        Brain Stimul. 2017; https://doi.org/10.1016/j.brs.2017.12.008
        • Boutron I.
        • Guittet L.
        • Estellat C.
        • Moher D.
        • Hróbjartsson A.
        • Ravaud P.
        Reporting methods of blinding in randomized trials assessing nonpharmacological treatments.
        PLoS Med. 2007; 4: e61https://doi.org/10.1371/journal.pmed.0040061
        • Alonzo A.
        • Aaronson S.
        • Bikson M.
        • Husain M.
        • Lisanby S.
        • Martin D.
        • et al.
        Study design and methodology for a multicentre, randomised controlled trial of transcranial direct current stimulation as a treatment for unipolar and bipolar depression.
        Contemp Clin Trials. 2016; 51: 65-71https://doi.org/10.1016/j.cct.2016.10.002
        • Razza L.B.
        • Moffa A.H.
        • Moreno M.L.
        • Carvalho A.F.
        • Padberg F.
        • Fregni F.
        • et al.
        A systematic review and meta-analysis on placebo response to repetitive transcranial magnetic stimulation for depression trials.
        Prog Neuro-Psychopharmacol Biol Psychiatry. 2018; 81: 105-113https://doi.org/10.1016/j.pnpbp.2017.10.016
        • Wood L.
        • Egger M.
        • Gluud L.L.
        • Schulz K.F.
        • Jüni P.
        • Altman D.G.
        • et al.
        Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study.
        BMJ. 2008; 336: 601-605https://doi.org/10.1136/bmj.39465.451748.AD
        • Kessler S.K.
        • Turkeltaub P.E.
        • Benson J.G.
        • Hamilton R.H.
        Differences in the experience of active and sham transcranial direct current stimulation.
        Brain Stimul. 2012; 5: 155-162https://doi.org/10.1016/j.brs.2011.02.007
        • Brunoni A.R.
        • Schestatsky P.
        • Lotufo P.A.
        • Benseñor I.M.
        • Fregni F.
        Comparison of blinding effectiveness between sham tDCS and placebo sertraline in a 6-week major depression randomized clinical trial.
        Clin Neurophysiol. 2014; 125: 298-305
        • Wallace D.
        • Cooper N.R.
        • Paulmann S.
        • Fitzgerald P.B.
        • Russo R.
        Perceived comfort and blinding efficacy in randomised sham-controlled transcranial direct current stimulation (tDCS) trials at 2 mA in young and older healthy adults.
        PLoS One. 2016; 11 (e0149703)https://doi.org/10.1371/journal.pone.0149703
        • Dagan M.
        • Herman T.
        • Harrison R.
        • Zhou J.
        • Giladi N.
        • Ruffini G.
        • et al.
        Multitarget transcranial direct current stimulation for freezing of gait in Parkinson's disease: multitarget tDCS for freezing of gait in PD.
        Mov Disord. 2018; 33: 642-646https://doi.org/10.1002/mds.27300
        • Richardson J.D.
        • Fillmore P.
        • Datta A.
        • Truong D.
        • Bikson M.
        • Fridriksson J.
        Toward development of sham protocols for high-definition transcranial direct current stimulation (HD-tDCS).
        NeuroRegulation. 2014; 1: 62
        • Ruffini G.
        • Fox M.D.
        • Ripolles O.
        • Miranda P.C.
        • Pascual-Leone A.
        Optimization of multifocal transcranial current stimulation for weighted cortical pattern targeting from realistic modeling of electric fields.
        Neuroimage. 2014; 89: 216-225https://doi.org/10.1016/j.neuroimage.2013.12.002
        • McFadden J.L.
        • Borckardt J.J.
        • George M.S.
        • Beam W.
        Reducing procedural pain and discomfort associated with transcranial direct current stimulation.
        Brain Stimul. 2011; 4: 38-42https://doi.org/10.1016/j.brs.2010.05.002
        • Guarienti F.
        • Caumo W.
        • Shiozawa P.
        • Cordeiro Q.
        • Boggio P.S.
        • Benseñor I.M.
        • et al.
        Reducing transcranial direct current stimulation-induced erythema with skin pretreatment: considerations for sham-controlled clinical trials: ketoprofen 2% in tDCS-induced erythema.
        Neuromodulation Technol Neural Interface. 2015; 18: 261-265https://doi.org/10.1111/ner.12230
        • Bikson M.
        • Paneri B.
        • Mourdoukoutas A.
        • Esmaeilpour Z.
        • Badran B.W.
        • Azzam R.
        • et al.
        Limited output transcranial electrical stimulation (LOTES-2017): engineering principles, regulatory statutes, and industry standards for wellness, over-the-counter, or prescription devices with low risk.
        Brain Stimul. 2018; 11: 134-157
        • Ezquerro F.
        • Moffa A.H.
        • Bikson M.
        • Khadka N.
        • Aparicio L.V.M.
        • Sampaio-Junior B de
        • et al.
        The influence of skin redness on blinding in transcranial direct current stimulation studies: a crossover trial: erythema and tDCS blinding.
        Neuromodulation Technol Neural Interface. 2016; https://doi.org/10.1111/ner.12527
        • Antal A.
        • Alekseichuk I.
        • Bikson M.
        • Brockmöller J.
        • Brunoni A.R.
        • Chen R.
        • et al.
        Low intensity transcranial electric stimulation: safety, ethical, legal regulatory and application guidelines.
        Clin Neurophysiol. 2017; 128: 1774-1809https://doi.org/10.1016/j.clinph.2017.06.001
        • Fertonani A.
        • Ferrari C.
        • Miniussi C.
        What do you feel if I apply transcranial electric stimulation? Safety, sensations and secondary induced effects.
        Clin Neurophysiol. 2015; 126: 2181-2188https://doi.org/10.1016/j.clinph.2015.03.015
        • Huey E.D.
        • Probasco J.C.
        • Moll J.
        • Stocking J.
        • Ko M.-H.
        • Grafman J.
        • et al.
        No effect of DC brain polarization on verbal fluency in patients with advanced frontotemporal dementia.
        Clin Neurophysiol. 2007; 118: 1417-1418
        • Axelrod V.
        • Rees G.
        • Lavidor M.
        • Bar M.
        Increasing propensity to mind-wander with transcranial direct current stimulation.
        Proc Natl Acad Sci. 2015; 112: 3314-3319
        • Lefaucheur J.-P.
        • Antal A.
        • Ayache S.S.
        • Benninger D.H.
        • Brunelin J.
        • Cogiamanian F.
        • et al.
        Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS).
        Clin Neurophysiol. 2017; 128: 56-92https://doi.org/10.1016/j.clinph.2016.10.087
        • Nitsche M.A.
        • Cohen L.G.
        • Wassermann E.M.
        • Priori A.
        • Lang N.
        • Antal A.
        • et al.
        Transcranial direct current stimulation: state of the art 2008.
        Brain Stimul. 2008; 1: 206-223https://doi.org/10.1016/j.brs.2008.06.004
        • Priori A.
        • Berardelli A.
        • Rona S.
        • Accornero N.
        • Manfredi M.
        Polarization of the human motor cortex through the scalp.
        Neuroreport. 1998; 9: 2257-2260
        • Antal A.
        • Polania R.
        • Schmidt-Samoa C.
        • Dechent P.
        • Paulus W.
        Transcranial direct current stimulation over the primary motor cortex during fMRI.
        Neuroimage. 2011; 55: 590-596https://doi.org/10.1016/j.neuroimage.2010.11.085
        • Kuo M.-F.
        • Paulus W.
        • Nitsche M.A.
        Sex differences in cortical neuroplasticity in humans.
        Neuroreport. 2006; 17: 1703-1707https://doi.org/10.1097/01.wnr.0000239955.68319.c2
        • Furubayashi T.
        • Terao Y.
        • Arai N.
        • Okabe S.
        • Mochizuki H.
        • Hanajima R.
        • et al.
        Short and long duration transcranial direct current stimulation (tDCS) over the human hand motor area.
        Exp Brain Res. 2008; 185: 279-286https://doi.org/10.1007/s00221-007-1149-z
        • Javadi A.H.
        • Cheng P.
        • Walsh V.
        Short duration transcranial direct current stimulation (tDCS) modulates verbal memory.
        Brain Stimul. 2012; 5: 468-474https://doi.org/10.1016/j.brs.2011.08.003
        • Nitsche M.A.
        • Paulus W.
        Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation.
        J Physiol. 2000; 527: 633-639https://doi.org/10.1111/j.1469-7793.2000.t01-1-00633.x
        • Peña-Gómez C.
        • Sala-Lonch R.
        • Junqué C.
        • Clemente I.C.
        • Vidal D.
        • Bargalló N.
        • et al.
        Modulation of large-scale brain networks by transcranial direct current stimulation evidenced by resting-state functional MRI.
        Brain Stimul. 2012; 5: 252-263https://doi.org/10.1016/j.brs.2011.08.006
        • Stagg C.J.
        • Lin R.L.
        • Mezue M.
        • Segerdahl A.
        • Kong Y.
        • Xie J.
        • et al.
        Widespread modulation of cerebral perfusion induced during and after transcranial direct current stimulation applied to the left dorsolateral prefrontal cortex.
        J Neurosci. 2013; 33: 11425-11431https://doi.org/10.1523/JNEUROSCI.3887-12.2013
        • Dyke K.
        • Kim S.
        • Jackson G.M.
        • Jackson S.R.
        Intra-subject consistency and reliability of response following 2 mA transcranial direct current stimulation.
        Brain Stimul. 2016; 9: 819-825https://doi.org/10.1016/j.brs.2016.06.052
        • Nikolin S.
        • Martin D.
        • Loo C.K.
        • Boonstra T.W.
        Effects of TDCS dosage on working memory in healthy participants.
        Brain Stimul. 2018; https://doi.org/10.1016/j.brs.2018.01.003
        • Boonstra T.W.
        • Nikolin S.
        • Meisener A.-C.
        • Martin D.M.
        • Loo C.K.
        Change in mean frequency of resting-state electroencephalography after transcranial direct current stimulation.
        Front Hum Neurosci. 2016; 10: 270https://doi.org/10.3389/fnhum.2016.00270
        • Creutzfeldt O.D.
        • Fromm G.H.
        • Kapp H.
        Influence of transcortical dc currents on cortical neuronal activity.
        Exp Neurol. 1962; 5: 436-452
        • Reato D.
        • Rahman A.
        • Bikson M.
        • Parra L.C.
        Low-intensity electrical stimulation affects network dynamics by modulating population rate and spike timing.
        J Neurosci. 2010; 30: 15067-15079https://doi.org/10.1523/JNEUROSCI.2059-10.2010
        • Francis J.T.
        • Gluckman B.J.
        • Schiff S.J.
        Sensitivity of neurons to weak electric fields.
        J Neurosci Off J Soc Neurosci. 2003; 23: 7255-7261
        • Martiny K.
        • Lunde M.
        • Bech P.
        Transcranial low voltage pulsed electromagnetic fields in patients with treatment-resistant depression.
        Biol Psychiatry. 2010; 68: 163-169https://doi.org/10.1016/j.biopsych.2010.02.017
        • Leuchter A.F.
        • Cook I.A.
        • Feifel D.
        • Goethe J.W.
        • Husain M.
        • Carpenter L.L.
        • et al.
        Efficacy and safety of low-field synchronized transcranial magnetic stimulation (sTMS) for treatment of major depression.
        Brain Stimul. 2015; 8: 787-794https://doi.org/10.1016/j.brs.2015.05.005
        • Schwarzkopf D.S.
        • Silvanto J.
        • Rees G.
        Stochastic resonance effects reveal the neural mechanisms of transcranial magnetic stimulation.
        J Neurosci. 2011; 31: 3143-3147https://doi.org/10.1523/JNEUROSCI.4863-10.2011
        • Brunoni A.R.
        • Moffa A.H.
        • Sampaio-Junior B.
        • Borrione L.
        • Moreno M.L.
        • Fernandes R.A.
        • et al.
        Trial of electrical direct-current Therapy versus escitalopram for depression.
        N Engl J Med. 2017; 376: 2523-2533https://doi.org/10.1056/NEJMoa1612999
        • Pavlova E.L.
        • Menshikova A.A.
        • Semenov R.V.
        • Bocharnikova E.N.
        • Gotovtseva G.N.
        • Druzhkova T.A.
        • et al.
        Transcranial direct current stimulation of 20- and 30-minutes combined with sertraline for the treatment of depression.
        Prog Neuro-Psychopharmacol Biol Psychiatry. 2018; 82: 31-38https://doi.org/10.1016/j.pnpbp.2017.12.004
        • Sampaio-Junior B.
        • Tortella G.
        • Borrione L.
        • Moffa A.H.
        • Machado-Vieira R.
        • Cretaz E.
        • et al.
        Efficacy and safety of transcranial direct current stimulation as an add-on treatment for bipolar depression: a randomized clinical trial.
        JAMA Psychiatry. 2018; 75: 158https://doi.org/10.1001/jamapsychiatry.2017.4040
        • Loo C.K.
        • Husain M.M.
        • McDonald W.M.
        • Aaronson S.
        • O'Reardon J.P.
        • Alonzo A.
        • et al.
        International randomized-controlled trial of transcranial Direct Current Stimulation in depression.
        Brain Stimul. 2018; 11: 125-133https://doi.org/10.1016/j.brs.2017.10.011
        • Gandiga P.C.
        • Hummel F.C.
        • Cohen L.G.
        Transcranial DC stimulation (tDCS): a tool for double-blind sham-controlled clinical studies in brain stimulation.
        Clin Neurophysiol. 2006; 117: 845-850https://doi.org/10.1016/j.clinph.2005.12.003
        • Palm U.
        • Reisinger E.
        • Keeser D.
        • Kuo M.-F.
        • Pogarell O.
        • Leicht G.
        • et al.
        Evaluation of sham transcranial direct current stimulation for randomized, placebo-controlled clinical trials.
        Brain Stimul. 2013; 6: 690-695https://doi.org/10.1016/j.brs.2013.01.005
        • Wörsching J.
        • Padberg F.
        • Ertl-Wagner B.
        • Kumpf U.
        • Kirsch B.
        • Keeser D.
        Imaging transcranial direct current stimulation (tDCS) of the prefrontal cortex—correlation or causality in stimulation-mediated effects?.
        Neurosci Biobehav Rev. 2016; 69: 333-356https://doi.org/10.1016/j.neubiorev.2016.08.001
        • Lefaucheur J.-P.
        A comprehensive database of published tDCS clinical trials (2005–2016).
        Neurophysiol Clin Neurophysiol. 2016; 46: 319-398https://doi.org/10.1016/j.neucli.2016.10.002
        • Margraf J.
        • Ehlers A.
        • Roth W.T.
        • Clark D.B.
        • Sheikh J.
        • Agras W.S.
        • et al.
        How“ blind” are double-blind studies?.
        J Consult Clin Psychol. 1991; 59: 184
        • White K.
        • Kando J.
        • Park T.
        • Waternaux C.
        • Brown W.A.
        Side effects and the“ blindability” of clinical drug trials.
        Am J Psychiatry. 1992; 149 (1730-1)
        • Quitkin F.M.
        Placebos, drug effects, and study design: a clinician's guide.
        Am J Psychiatry. 1999; 156: 829-836
        • Moncrieff J.
        A comparison of antidepressant trials using active and inert placebos.
        Int J Methods Psychiatr Res. 2003; 12: 117-127
        • Borckardt J.J.
        • Walker J.
        • Branham R.K.
        • Rydin-Gray S.
        • Hunter C.
        • Beeson H.
        • et al.
        Development and evaluation of a portable sham transcranial magnetic stimulation system.
        Brain Stimul. 2008; 1: 52-59https://doi.org/10.1016/j.brs.2007.09.003
        • Baethge C.
        • Assall O.P.
        • Baldessarini R.J.
        Systematic review of blinding assessment in randomized controlled trials in schizophrenia and affective disorders 2000-2010.
        Psychother Psychosom. 2013; 82: 152-160https://doi.org/10.1159/000346144
        • Davidson R.J.
        • Kaszniak A.W.
        Conceptual and methodological issues in research on mindfulness and meditation.
        Am Psychol. 2015; 70: 581-592https://doi.org/10.1037/a0039512
        • Patterson B.
        • Boyle M.H.
        • Kivlenieks M.
        • Van Ameringen M.
        The use of waitlists as control conditions in anxiety disorders research.
        J Psychiatr Res. 2016; 83: 112-120https://doi.org/10.1016/j.jpsychires.2016.08.015
        • Benedetti F.
        Placebo effects: from the neurobiological paradigm to translational implications.
        Neuron. 2014; 84: 623-637https://doi.org/10.1016/j.neuron.2014.10.023
        • Kaptchuk T.J.
        • Goldman P.
        • Stone D.A.
        • Stason W.B.
        Do medical devices have enhanced placebo effects?.
        J Clin Epidemiol. 2000; 53: 786-792
        • Kaptchuk T.J.
        • Miller F.G.
        Placebo effects in medicine.
        N Engl J Med. 2015; 373: 8-9
        • Burke M.J.
        • Kaptchuk T.J.
        • Pascual-Leone A.
        Challenges of differential placebo effects in contemporary medicine: the example of brain stimulation: differential placebo effects and brain stimulation.
        Ann Neurol. 2018; https://doi.org/10.1002/ana.25387
        • Rochas V.
        • Gelmini L.
        • Krolak-Salmon P.
        • Poulet E.
        • Saoud M.
        • Brunelin J.
        • et al.
        Disrupting pre-SMA activity impairs facial happiness recognition: an event-related TMS study.
        Cerebr Cortex. 2013; 23: 1517-1525https://doi.org/10.1093/cercor/bhs133
        • Kober S.E.
        • Witte M.
        • Grinschgl S.
        • Neuper C.
        • Wood G.
        Placebo hampers ability to self-regulate brain activity: a double-blind sham-controlled neurofeedback study.
        Neuroimage. 2018; 181: 797-806https://doi.org/10.1016/j.neuroimage.2018.07.025
        • Wörsching J.
        • Padberg F.
        • Goerigk S.
        • Heinz I.
        • Bauer C.
        • Plewnia C.
        • et al.
        Testing assumptions on prefrontal transcranial direct current stimulation: comparison of electrode montages using multimodal fMRI.
        Brain Stimul. 2018; 11: 998-1007
        • Fonteneau C.
        • Redoute J.
        • Haesebaert F.
        • Le Bars D.
        • Costes N.
        • Suaud-Chagny M.-F.
        • et al.
        Frontal transcranial direct current stimulation induces dopamine release in the ventral striatum in human.
        Cerebr Cortex. 2018; 28: 2636-2646
        • Horvath J.C.
        • Forte J.D.
        • Carter O.
        Evidence that transcranial direct current stimulation (tDCS) generates little-to-no reliable neurophysiologic effect beyond MEP amplitude modulation in healthy human subjects: a systematic review.
        Neuropsychologia. 2015; 66: 213-236https://doi.org/10.1016/j.neuropsychologia.2014.11.021
        • Antal A.
        • Keeser D.
        • Priori A.
        • Padberg F.
        • Nitsche M.A.
        Conceptual and procedural shortcomings of the systematic review “evidence that transcranial direct current stimulation (tDCS) generates little-to-no reliable neurophysiologic effect beyond MEP amplitude modulation in healthy human subjects: a systematic review” by horvath and co-workers.
        Brain Stimul. 2015; 8: 846-849https://doi.org/10.1016/j.brs.2015.05.010
        • Peterchev A.V.
        • Wagner T.A.
        • Miranda P.C.
        • Nitsche M.A.
        • Paulus W.
        • Lisanby S.H.
        • et al.
        Fundamentals of transcranial electric and magnetic stimulation dose: definition, selection, and reporting practices.
        Brain Stimul. 2012; 5: 435-453https://doi.org/10.1016/j.brs.2011.10.001
        • Dissanayaka T.D.
        • Zoghi M.
        • Farrell M.
        • Egan G.F.
        • Jaberzadeh S.
        Sham transcranial electrical stimulation and its effects on corticospinal excitability: a systematic review and meta-analysis.
        Rev Neurosci. 2018; 29: 223-232https://doi.org/10.1515/revneuro-2017-0026