Variability in response to transcranial direct current stimulation of the motor cortex

Background: Responses to a number of different plasticity-inducing brain stimulation protocols are highly variable. However there is little data available on the variability of response to transcranial direct current stimulation (TDCS).

Objective: We tested the effects of TDCS over the motor cortex on corticospinal excitability. We also examined whether an individual's response could be predicted from measurements of onset latency of motor evoked potential (MEP) following stimulation with different orientations of monophasic transcranial magnetic stimulation (TMS).

Methods: Fifty-three healthy subjects participated in a crossover-design. Baseline latency measurements with different coil orientations and MEPs were recorded from the first dorsal interosseous muscle prior to the application of 10 min of 2 mA TDCS (0.057 mA/cm2). Thirty MEPs were measured every 5 min for up to half an hour after the intervention to assess after-effects on corticospinal excitability.

Results: Anodal TDCS at 2 mA facilitated MEPs whereas there was no significant effect of 2 mA cathodal TDCS. A two-step cluster analysis suggested that approximately 50% individuals had only a minor, or no response to TDCS whereas the remainder had a facilitatory effect to both forms of stimulation. There was a significant correlation between the latency difference of MEPs (anterior-posterior stimulation minus latero-medial stimulation) and the response to anodal, but not cathodal TDCS.

Conclusions: The large variability in response to these TDCS protocols is in line with similar studies using other forms of non-invasive brain stimulation. The effects highlight the need to develop more robust protocols, and understand the individual factors that determine responsiveness.