Effect of transcranial direct current stimulation on exercise performance: A systematic review and meta-analysis |
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| Authors: | Daniel G da S Machado Gozde Unal Suellen M Andrade Alexandre Moreira Leandro R Altimari André R Brunoni Stéphane Perrey Alexis R Mauger Marom Bikson Alexandre H Okano |
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| Institution: | 1. Graduate Program in Physical Education, State University of Londrina, Londrina, PR, Brazil;2. Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY, USA;3. Graduate Program on Cognitive and Behavioral Neuroscience, Federal University of Paraiba, João Pessoa, PB, Brazil;4. School of Physical Education and Sport, University of São Paulo, São Paulo, SP, Brazil;5. Laboratory of Neurosciences (LIM-27), University of São Paulo, SP, Brazil;6. EuroMov, University of Montpellier, Montpellier, France;7. School of Sport & Exercise Sciences, University of Kent, Kent, United Kingdom;8. Center of Mathematics, Computation, and Cognition, Universidade Federal do ABC, São Bernardo do Campo, SP, Brazil |
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| Abstract: | BackgroundTranscranial direct current stimulation (tDCS) has been used to improve exercise performance, though the protocols used, and results found are mixed.ObjectiveWe aimed to analyze the effect of tDCS on improving exercise performance.MethodsA systematic search was performed on the following databases, until December 2017: PubMed/MEDLINE, Embase, Web of Science, SCOPUS, and SportDiscus. Full-text articles that used tDCS for exercise performance improvement in adults were included. We compared the effect of anodal (anode near nominal target) and cathodal (cathode near nominal target) tDCS to a sham/control condition on the outcome measure (performance in isometric, isokinetic or dynamic strength exercise and whole-body exercise).Results22 studies (393 participants) were included in the qualitative synthesis and 11 studies (236 participants) in the meta-analysis. The primary motor cortex (M1) was the main nominal tDCS target (n?=?16; 72.5%). A significant effect favoring anodal tDCS (a-tDCS) applied before exercise over M1 was found on cycling time to exhaustion (mean difference?=?93.41?s; 95%CI?=?27.39?s–159.43?s) but this result was strongly influenced by one study (weight?=?84%), no effect was found for cathodal tDCS (c-tDCS). No significant effect was found for a-tDCS applied on M1 before or during exercise on isometric muscle strength of the upper or lower limbs. Studies regarding a-tDCS over M1 on isokinetic muscle strength presented mixed results. Individual results of studies using a-tDCS applied over the prefrontal and motor cortices either before or during dynamic muscle strength testing showed positive results, but performing meta-analysis was not possible.ConclusionFor the protocols tested, a-tDCS but not c-tDCS vs. sham over M1 improved exercise performance in cycling only. However, this result was driven by a single study, which when removed was no longer significant. Further well-controlled studies with larger sample sizes and broader exploration of the tDCS montages and doses are warranted. |
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| Keywords: | Athletic performance Sports performance Meta-analysis Non-invasive brain stimulation Fatigue Neuromodulation |
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