Abstract
BackgroundTranscranial electrical stimulation is a promising technique to facilitate behavioural improvements in neurological and psychiatric populations. Recently there has been interest in remote delivery of stimulation within a participant’s home.ObjectiveThe purpose of this review is to identify strategies employed to implement and monitor in-home stimulation and identify whether these approaches are associated with protocol adherence, adverse events and patient perspectives.MethodsMEDLINE, Embase Classic + Embase, Emcare and PsycINFO databases and clinical trial registries were searched to identify studies which reported primary data for any type of transcranial electrical stimulation applied as a home-based treatment.ResultsNineteen published studies from unique trials and ten on-going trials were included. For published data, internal validity was assessed with the Cochrane risk of bias assessment tool with most studies exhibiting a high level of bias possibly reflecting the preliminary nature of current work. Several different strategies were employed to prepare the participant, deliver and monitor the in-home transcranial electrical stimulation. The use of real time videoconferencing to monitor in-home transcranial electrical stimulation appeared to be associated with higher levels of compliance with the stimulation protocol and greater participant satisfaction. There were no severe adverse events associated with in-home stimulation.ConclusionsDelivery of transcranial electrical stimulation within a person’s home offers many potential benefits and appears acceptable and safe provided appropriate preparation and monitoring is provided. Future in-home transcranial electrical stimulation studies should use real-time videoconferencing as one of the approaches to facilitate delivery of this potentially beneficial treatment.
Highlights
Transcranial electrical stimulation is a technique used to modulate cortical function and human behaviour
Following title and abstract screening, 48 studies remained and full text articles of those studies were screened for eligibility
One additional study [37] was excluded from this review as it was identified through communication with the author that the data came from a trial that was already included within the review [38]
Summary
Transcranial electrical stimulation (tES) is a technique used to modulate cortical function and human behaviour. Positioning the cathode over the target cortical region causes hyperpolarisation and a decrease in spontaneous firing rates [4]. This modulation of cortical activity can be observed beyond the period of stimulation and is thought to be mediated by mechanisms which resemble long term potentiation and depression [5]. Transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNS) are forms of tES Both tACS and tRNS are thought to interact with ongoing oscillatory cortical rhythms in a frequency dependent manner to influence human behaviour [6–8]. There has been interest in remote delivery of stimulation within a participant’s home
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