Helmholtz lecture by Andrea Antal: Transcranial direct and alternating current stimulation in the clinical practice

Andrea Antal, Department of Neurology, University Medical Center Göttingen, Germany: Transcranial direct and alternating current stimulation in the clinical practice

The number of patients with neurological and psychiatric disorders, such as chronic pain, Parkinson’s and Alzheimer diseases, depression and cognitive decline, has increased over the past decade, representing a prominent health problem worldwide. While pharmacological therapies can reduce symptoms in some patients, individuals often experience adverse effects and can develop tolerance to medications whereby they become less effective. In such cases, transcranial brain stimulation (TBS) of the neural circuitry underlying the disease represents a promising treatment modality. TBS is among the most dynamically developing areas of research in neuroscience. It acts on grey and white matter to modulate neural activity by delivering electric or magnetic energy to targeted areas using specific temporal and spatial patterns. Although TBS has been used with some success for over 20 years in clinical practice, it suffers from time-intensive trial-and-error parameter refinement in patients and highly variable outcomes. Computational simulations are increasingly being used to model the interaction between electric or magnetic stimulation, neural anatomy, and endogenous brain dynamics in order to understand the mechanisms of stimulation, but there is still so much work ahead. Combining brain stimulation with brain imaging, individualizing stimulation protocols, predicting treatment response, identifying biomarkers are representing important and thriving developments currently worked on in many labs worldwide. The aim of the present lecture is to shortly summarize these developments, using transcranial direct and alternating current stimulation.