IEEE misleads its readers about the effects of transcranial direct current stimulation
Joel's comments:
The news report below from IEEE Spectrum attacks the efficacy of transcranial direct current stimulation (tDCS) based upon the results of a meta-analysis.
This news report, however, failed to mention that the review only examined studies of single-session therapy. Moreover, the report did not discuss the other limitations of this paper:
According to the paper ...
This news report, however, failed to mention that the review only examined studies of single-session therapy. Moreover, the report did not discuss the other limitations of this paper:
According to the paper ...
"A major limitation of this analysis is the lack of comparable research available in the current tDCS literature. Of the 50 cognitive outcome measures replicated between two different research groups included in this paper, 35 include only 2 or 3 papers. Accordingly, these analyses must be interpreted with caution. It is worth noting, however, that of these 35 outcome measures, 25 include papers report opposing effect sizes. This means >70% of analyses which include only 2 or 3 papers contain at least 1 paper reporting enhancement and at least 1 paper reporting impairment following tDCS. As noted above, this may be due to varied state-dependency effects between different studies. Until more direct replication of older research is undertaken and more data are made available for pooling, it is difficult to conclude the true effect of this device."
"our findings do not preclude the possibility that tDCS has an effect on different populations (juvenile, elderly, infirm), when utilized multiple-times over several days or weeks, or on behavioral tasks. Nor does this preclude the possibility that tDCS could be effective if utilized in a novel fashion (hi-definition tDCS, spinal tDCS, pulsed current tDCS, etc.)."
Given the "lack of comparable research available in the current tDCS literature," I question whether it was appropriate to conduct a meta-analysis.
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Brain Hackers Beware: Scientist Says tDCS Has No Effect
New research from Australia calls into question the dramatic claims made for transcranial brain stimulation
Mark Harris, IEEE Spectrum, Jan 21, 2015
The largest meta-analysis yet of the ability of one kind of electrical brain stimulation technology to alter how people think and feel has found no evidence that it has any effect on healthy adults.
Jared Horvath, a neuroscientist at the University of Melbourne, in Australia, looked at every study of transcranial direct current stimulation (tDCS) that reported an impact on cognitive and behavioral activities such as problem solving, learning, mental arithmetic, vision tasks, and memory games. He then excluded results that had not been replicated by other researchers, as well as any experiments lacking a “sham condition” control group—where participants were connected to the device but didn’t receive current. While many of the more than 200 individual studies that remained claimed to have found significant effects, those effects disappeared after Horvath’s number crunching. “When I pulled out the 20 studies looking at tDCS and working memory, for example, they all found something, but they all found something different,” says Horvath.
One study may have found an effect on accuracy, another on reaction time, and a third on response confidence. “But when I brought them together, they just canceled each other out, and I was left with nothing,” he says. It was a similar story for more than 100 other cognitive and behavioral outcomes. “It looks like the evidence says tDCS is not doing anything.”
“Individual differences can mask effects and even lead to opposite results”—Roi Cohen Kadosh, University of OxfordThis news may come as a shock to the thousands of DIY brain hackers who have been building and using tDCS devices in the hope of boosting their brainpower at the push of a button. Many of those biohackers constructed their own brain zappers from 9-volt batteries and simple circuits for as little as US $10. The impact of Horvath’s paper could be even more serious for companies hoping to sell designer tDCS machines, for much higher sums, to a mainstream audience as “cognitive enhancement devices.”
Felipe Fregni, director of the Laboratory of Neuromodulation at Harvard Medical School, shares some of Horvath’s caution but is adamant that the technology has been proved. “tDCS is not a magic…bullet, and the effects are very small,” he says. “But we’ve seen over and over in different studies that it helps you to learn new skills. It helps you to activate neural networks that were deactivated or never used before.”
“There’s probably someone out there that this really works for,” admits Horvath. “But if it only works for one person, one time, is that really an effect, or is it a placebo or some statistical anomaly you can’t repeat? And for all those outcomes that have been repeated, there are almost twice as many that haven’t been replicated. A huge body of the literature are one-offs.”
Horvath’s latest results, which were presented at the Australasian Society for Cognitive Science conference in December, follow hot on the heels of another meta-analysis he conducted. That one found that tDCS did not have any significant physiological effects on the brain.
“We want tDCS to work so bad that we’re forgetting the foundational stuff that we should be focusing on”—Jared Horvath, University of MelbourneThe new findings do not surprise Jamie Tyler, a neuroscientist at Arizona State University and chief science officer of Thync, a start-up that raised $13 million to launch a smartphone-controlled tDCS device at the Consumer Electronics Show last week. “This meta-analysis is not shocking to me at all,” he says. “We tried to replicate some basic tDCS findings and did not find an effect on any of those cognitive parameters either.”
Tyler claims to have then gone back to the drawing board, using a new (and unpublished) approach to tDCS that generates reliable psychological responses. Thync’s device will be marketed as producing either energetic or stress-busting neurosignaling electrical waveforms that Tyler calls “vibes.” But even with his modified tDCS technology, Tyler says that his company has found no effects on cognition.
Not every neuroscientist is as quick to dismiss decades of tDCS research. “Individual differences can mask effects and even lead to opposite results,” says Roi Cohen Kadosh of the University of Oxford, in England. He recently published research showing that identical tDCS stimulation in people who were either nervous or confident about their mathematical abilities produced opposite behavioral and physiological effects. The anxious mathematicians improved their skills, while the skills of the confident ones deteriorated. Over a large enough population, he says, any such positive and negative effects would average out to nothing. “It is highly likely that the research groups are sampling their participants from a similar environment [usually undergraduate students] and therefore reducing the impact of individual differences,” says Kadosh.
In the past, meta-analyses of tDCS for medical problems such as depression and chronic pain have suggested that it may have beneficial effects in a clinical setting. Horvath admits that much more research needs to be done. “We want tDCS to work so bad that we’re forgetting the foundational stuff that we should be focusing on, systematic research just changing one variable at a time,” he says. “That’s going to kick our butt, because if you don’t have a solid foundation, sooner or later the whole thing crumbles.”
About the AuthorContributing editor Mark Harris has been delving into the history of Google’s self-driving car project for IEEE Spectrum and other publications. Before that he investigated the reason that Kodak’s patent portfolio fetched such a pittance.
Jared Horvath, a neuroscientist at the University of Melbourne, in Australia, looked at every study of transcranial direct current stimulation (tDCS) that reported an impact on cognitive and behavioral activities such as problem solving, learning, mental arithmetic, vision tasks, and memory games. He then excluded results that had not been replicated by other researchers, as well as any experiments lacking a “sham condition” control group—where participants were connected to the device but didn’t receive current. While many of the more than 200 individual studies that remained claimed to have found significant effects, those effects disappeared after Horvath’s number crunching. “When I pulled out the 20 studies looking at tDCS and working memory, for example, they all found something, but they all found something different,” says Horvath.
One study may have found an effect on accuracy, another on reaction time, and a third on response confidence. “But when I brought them together, they just canceled each other out, and I was left with nothing,” he says. It was a similar story for more than 100 other cognitive and behavioral outcomes. “It looks like the evidence says tDCS is not doing anything.”
“Individual differences can mask effects and even lead to opposite results”—Roi Cohen Kadosh, University of OxfordThis news may come as a shock to the thousands of DIY brain hackers who have been building and using tDCS devices in the hope of boosting their brainpower at the push of a button. Many of those biohackers constructed their own brain zappers from 9-volt batteries and simple circuits for as little as US $10. The impact of Horvath’s paper could be even more serious for companies hoping to sell designer tDCS machines, for much higher sums, to a mainstream audience as “cognitive enhancement devices.”
Felipe Fregni, director of the Laboratory of Neuromodulation at Harvard Medical School, shares some of Horvath’s caution but is adamant that the technology has been proved. “tDCS is not a magic…bullet, and the effects are very small,” he says. “But we’ve seen over and over in different studies that it helps you to learn new skills. It helps you to activate neural networks that were deactivated or never used before.”
“There’s probably someone out there that this really works for,” admits Horvath. “But if it only works for one person, one time, is that really an effect, or is it a placebo or some statistical anomaly you can’t repeat? And for all those outcomes that have been repeated, there are almost twice as many that haven’t been replicated. A huge body of the literature are one-offs.”
Horvath’s latest results, which were presented at the Australasian Society for Cognitive Science conference in December, follow hot on the heels of another meta-analysis he conducted. That one found that tDCS did not have any significant physiological effects on the brain.
“We want tDCS to work so bad that we’re forgetting the foundational stuff that we should be focusing on”—Jared Horvath, University of MelbourneThe new findings do not surprise Jamie Tyler, a neuroscientist at Arizona State University and chief science officer of Thync, a start-up that raised $13 million to launch a smartphone-controlled tDCS device at the Consumer Electronics Show last week. “This meta-analysis is not shocking to me at all,” he says. “We tried to replicate some basic tDCS findings and did not find an effect on any of those cognitive parameters either.”
Tyler claims to have then gone back to the drawing board, using a new (and unpublished) approach to tDCS that generates reliable psychological responses. Thync’s device will be marketed as producing either energetic or stress-busting neurosignaling electrical waveforms that Tyler calls “vibes.” But even with his modified tDCS technology, Tyler says that his company has found no effects on cognition.
Not every neuroscientist is as quick to dismiss decades of tDCS research. “Individual differences can mask effects and even lead to opposite results,” says Roi Cohen Kadosh of the University of Oxford, in England. He recently published research showing that identical tDCS stimulation in people who were either nervous or confident about their mathematical abilities produced opposite behavioral and physiological effects. The anxious mathematicians improved their skills, while the skills of the confident ones deteriorated. Over a large enough population, he says, any such positive and negative effects would average out to nothing. “It is highly likely that the research groups are sampling their participants from a similar environment [usually undergraduate students] and therefore reducing the impact of individual differences,” says Kadosh.
In the past, meta-analyses of tDCS for medical problems such as depression and chronic pain have suggested that it may have beneficial effects in a clinical setting. Horvath admits that much more research needs to be done. “We want tDCS to work so bad that we’re forgetting the foundational stuff that we should be focusing on, systematic research just changing one variable at a time,” he says. “That’s going to kick our butt, because if you don’t have a solid foundation, sooner or later the whole thing crumbles.”
About the AuthorContributing editor Mark Harris has been delving into the history of Google’s self-driving car project for IEEE Spectrum and other publications. Before that he investigated the reason that Kodak’s patent portfolio fetched such a pittance.
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Jared Cooney Horvath, Jason D. Forte, Olivia Carter. Quantitative Review Finds No Evidence of Cognitive Effects in Healthy Populations from Single-Session Transcranial Direct Current Stimulation (tDCS). Brain Stimulation. Published Online: January 16, 2015. DOI: http://dx.doi.org/10.1016/j.
Highlights
- Of 42 replicated cognitive outcome measures included in 59 analyses, tDCS has a significant effect on zero
- There appears to be no reliable effect of tDCS on executive function, language, memory, or miscellaneous measures.
- Single-session tDCS does not appear to generate reliable cognitive effect in healthy populations
AbstractBackground Over the last 15-years, transcranial direct current stimulation (tDCS), a relatively novel form of neuromodulation, has seen a surge of popularity in both clinical and academic settings. Despite numerous claims suggesting that a single session of tDCS can modulate cognition in healthy adult populations (especially working memory and language production), the paradigms utilized and results reported in the literature are extremely variable. To address this, we conduct the largest quantitative review of the cognitive data to date.
Methods Single-session tDCS data in healthy adults (18-50) from every cognitive outcome measure reported by at least two different research groups in the literature was collected. Outcome measures were divided into 4 broad categories: executive function, language, memory, and miscellaneous. To account for the paradigmatic variability in the literature, we undertook a three-tier analysis system; each with less-stringent inclusion criteria than the prior. Standard mean difference values with 95%CIs were generated for included studies and pooled for each analysis.
Results Of the 59 analyses conducted, tDCS was found to not have a significant effect on any - regardless of inclusion laxity. This includes no effect on any working memory outcome or language production task.
Conclusion Our quantitative review does not support the idea that tDCS generates a reliable effect on cognition in healthy adults. Reasons for and limitations of this finding are discussed. This work raises important questions regarding the efficacy of tDCS, state-dependency effects, and future directions for this tool in cognitive research.
Methods Single-session tDCS data in healthy adults (18-50) from every cognitive outcome measure reported by at least two different research groups in the literature was collected. Outcome measures were divided into 4 broad categories: executive function, language, memory, and miscellaneous. To account for the paradigmatic variability in the literature, we undertook a three-tier analysis system; each with less-stringent inclusion criteria than the prior. Standard mean difference values with 95%CIs were generated for included studies and pooled for each analysis.
Results Of the 59 analyses conducted, tDCS was found to not have a significant effect on any - regardless of inclusion laxity. This includes no effect on any working memory outcome or language production task.
Conclusion Our quantitative review does not support the idea that tDCS generates a reliable effect on cognition in healthy adults. Reasons for and limitations of this finding are discussed. This work raises important questions regarding the efficacy of tDCS, state-dependency effects, and future directions for this tool in cognitive research.
Taken together, we have found no evidence that single-session tDCS has a reliable effect on cognitions in healthy adult populations. When this is combined with our previous work which suggested tDCS does not have a reliable effect on neurophysiologic measures beyond MEP amplitude [1], it becomes difficult avoid questions of device efficacy. It is important to note, however, that these findings may be due to state dependency effects which, with elucidation, can be controlled for and leveraged. In addition,our findings do not preclude the possibility that tDCS has an effect on different populations (juvenile, elderly, infirm), when utilized multiple-times over several days or weeks, or on behavioral tasks. Nor does this preclude the possibility that tDCS could be effective if utilized in a novel fashion (hi-definition tDCS, spinal tDCS, pulsed current tDCS, etc.). Despite this, as this field moves forward, it will be important future studies include measures which directly replicate prior work, explore potential state-dependent effects within and between studies, and report quantitative data for all explored outcome measures (so that a more clear picture of the state of the field can be derived).
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