Safety criteria for transcranial direct current stimulation (tDCS) in humans

@article{Nitsche2003SafetyCF,
  title={Safety criteria for transcranial direct current stimulation (tDCS) in humans},
  author={Michael A. Nitsche and David Liebetanz and Nicolas Lang and Andrea Antal and Frithjof Tergau and Walter Paulus},
  journal={Clinical Neurophysiology},
  year={2003},
  volume={114},
  pages={2220-2222}
}

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Transcranial electrical stimulation using weak current may be a promising tool to modulate cerebral excitability in a non‐invasive, painless, reversible, selective and focal way.

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It is apparent that the amount and distribution of current entering the brain is of great consequence, yet the literature discloses no systematic mathematical or experimental method for predicting current flow.

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TLDR
Recommendations have been made for the selection of electrical stimulus parameters to be used in central nervous system prostheses based on the relationship of charge density per phase and total charge to neural damage investigated after surface stimulation of the parietal cortex in normal cats.

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The results show that primary visual functions, such as contrast detection can be transiently altered by transcranial weak direct current stimulation, most probably modulating neural excitability, as has been shown in the motor cortex previously.

Considerations for safety in the use of extracranial stimulation for motor evoked potentials.

TLDR
Data indicate that the charge per phase used in most of the extracranial MEP protocols is sufficient to induce neural damage if the stimulation is applied continuously for several hours, and that low resistance paths between the stimulating electrode and the brain may give rise to foci of high charge density.