TY  - JOUR
AU  - Antal, Andrea
AU  - Bjekić, Jovana
AU  - Ganho-Ávila, Ana
AU  - Alekseichuk, Ivan
AU  - Assecondi, Sara
AU  - Bergmann, Til Ole
AU  - Bikson, Marom
AU  - Brunelin, Jerome
AU  - Brunoni, Andre R
AU  - Charvet, Leigh
AU  - Chen, Robert
AU  - Cohen Kadosh, Roi
AU  - Diedrich, Lukas
AU  - D'Urso, Giordano
AU  - Ferrucci, Roberta
AU  - Filipović, Saša R
AU  - Fitzgerald, Paul B
AU  - Flöel, Agnes
AU  - Fröhlich, Flavio
AU  - George, Mark S
AU  - Hamilton, Roy H
AU  - Haueisen, Jens
AU  - Hallett, Mark
AU  - Herrmann, Christoph S
AU  - Hummel, Friedhelm C
AU  - Jaberzadeh, Shapour
AU  - Langguth, Berthold
AU  - Lavidor, Michal
AU  - Lefaucheur, Jean-Pascal
AU  - Miniussi, Carlo
AU  - Moliadze, Vera
AU  - Nikander, Mika
AU  - Nikolin, Stevan
AU  - Nitsche, Michael A
AU  - Opitz, Alexander
AU  - O'Shea, Jacinta
AU  - Padberg, Frank
AU  - Plewnia, Christian
AU  - Priori, Alberto
AU  - Ramasawmy, Perianen
AU  - Razza, Lais B
AU  - Rossi, Simone
AU  - Rothwell, John
AU  - Rueger, Maria A
AU  - Ruffini, Giulio
AU  - Sack, Alexander T
AU  - Salvador, Ricardo
AU  - Schellhorn, Klaus
AU  - Schuhmann, Teresa
AU  - Shirota, Yuichiro
AU  - Siebner, Hartwig Roman
AU  - Thielscher, Axel
AU  - Ugawa, Yoshikazu
AU  - Uusitalo, Susanne
AU  - Wexler, Anna
AU  - Paulus, Walter
AU  - Vanderhasselt, Marie-Anne
AU  - Van Waes, Vincent
AU  - Wessel, Maximilian J
AU  - Wischnewski, Miles
AU  - Baeken, Chris
AU  - Ziemann, Ulf
TI  - Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines (2017-2025: An update) - endorsed by the European Society for Brain Stimulation (ESBS) and by the International Federation for Clinical Neurophysiology (IFCN).
JO  - Clinical neurophysiology
VL  - 184
SN  - 1388-2457
CY  - Amsterdam [u.a.]
PB  - Elsevier Science
M1  - DZNE-2026-00245
SP  - 2111436
PY  - 2026
AB  - This guideline summarizes updated safety data (2017-2025) and provides expert recommendations on the use of low intensity transcranial electrical stimulation (tES) in humans. tES encompasses several techniques including transcranial direct current stimulation (tDCS), oscillatory transcranial direct current stimulation (otDCS), transcranial alternating current stimulation (tACS), transcranial random noise stimulation (tRNS), transcranial temporal interference stimulation (tTIS), and their combinations or variations. Across over 300,000 sessions involving healthy individuals, patients with neuropsychiatric conditions, and other clinical populations, no tES-related serious adverse events (AEs) have been reported. Moderate AEs are rare and limited to a small range of specific applications. Mild AEs are common and include transient symptoms such as localized sensations (e.g., tingling or burning), headaches, and fatigue. Similar mild AEs are also reported by individuals receiving placebo stimulation. The frequency, magnitude, and type of AEs are comparable across healthy, clinical, and vulnerable groups, including children, elderly, or pregnant women. Combined interventions (e.g., co-application with EEG, TMS, or neuroimaging) have not shown increased safety risks. Safety is well-established for both bipolar and multichannel tES when applied up to 4 mA and up to 60 min per day. Higher intensities and longer stimulation durations may also be safe. Nevertheless, the number of studies using intensities above 4 mA or stimulating longer than 60 min is low. Home-based use of treatments is growing rapidly, leveraging remote supervision to provide patients with greater access and enable repeated, sustained dosing paradigms. We recommend using screening and AE questionnaires in future controlled studies, in particular when planning to extend the stimulation parameters applied. We discuss recent regulatory and ethical issues.
KW  - Humans
KW  - Transcranial Direct Current Stimulation: adverse effects
KW  - Transcranial Direct Current Stimulation: standards
KW  - Transcranial Direct Current Stimulation: methods
KW  - Transcranial Direct Current Stimulation: ethics
KW  - Societies, Medical: standards
KW  - Neurophysiology: legislation & jurisprudence
KW  - Neurophysiology: standards
KW  - Europe
KW  - Transcranial Magnetic Stimulation
KW  - Brain: physiology
KW  - Adverse events (Other)
KW  - Ethics (Other)
KW  - Regulation (Other)
KW  - Safety (Other)
KW  - Training (Other)
KW  - tACS (Other)
KW  - tDCS (Other)
KW  - tES (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:41622107
C2  - pmc:PMC7618810
DO  - DOI:10.1016/j.clinph.2025.2111436
UR  - https://pub.dzne.de/record/285468
ER  -