Application of Transcranial Direct Current Stimulation in Neurocritical Care

Mohammadreza  Hajiesmaeili; Reza  Goharani; Masood  Zangi; Mahdi  Amirdosara; Majid  Mokhtari

doi:10.18502/aacc.v12i2.20960

Mohammadreza Hajiesmaeili Critical Care Quality Improvement Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Reza Goharani Critical Care Quality Improvement Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Masood Zangi Critical Care Quality Improvement Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mahdi Amirdosara Critical Care Quality Improvement Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Majid Mokhtari Critical Care Quality Improvement Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v12i2.20960

Keywords: tDCS; Neuro-intensive care; Critical care; Transcranial direct current stimulation; Review

Abstract

Background: Transcranial direct current stimulation (tDCS) is an emerging, non-invasive neuromodulation technique with massive potential in neurocritical care settings. This review covers the applications, mechanisms, and outcomes of tDCS in patients with severe neurological disorders.

Methods: tDCS uses low-intensity direct current to modulate cortical excitability and induce neuroplasticity, which aids in recovering motor, cognitive, and sensory functions. Its simplicity and noninvasive nature enable bedside use, making it a good alternative to invasive interventions.

Results: The evidence suggests that tDCS improves recovery in stroke, TBI, and DOC by affecting synaptic plasticity, releasing neurotrophic factors, and improving cerebral perfusion. However, due to the variability in the methodology and stimulation parameters of the studies, further research is required to determine standardized protocols. Safety appears minimal, with most side effects including mild discomfort.

Conclusion: This review underlines the promise of tDCS as an adjunctive therapy in neurocritical care and recommends its integration into traditional rehabilitative strategies to enhance patient outcomes. Future studies should investigate optimizing stimulation parameters, long-term efficacy, and condition-specific applications to exploit tDCS's therapeutic benefits