Transcranial Electrical Stimulation (tES)
What Is It?
Plain-Language Explanation
Transcranial Electrical Stimulation (tES) uses very weak electrical current — far below the level you could consciously feel — to help nerve cells in the brain work more effectively. Small sponge-padded electrodes are placed on your scalp and a gentle current flows for 20–30 minutes.
You may feel a mild tingling or faint warmth under the electrodes. There are no needles, no pain, and you remain fully awake throughout the session.
Technical Explanation
tES encompasses tDCS (direct current), tACS (alternating current), and tRNS (random noise stimulation). In tDCS, a constant 1–2 mA current is delivered for 20–30 minutes via saline-soaked sponge electrodes (25–35 cm²). The anodal electrode increases neuronal excitability via subthreshold membrane depolarisation; the cathodal electrode reduces it.
Primary mechanisms include resting membrane potential shifts, NMDA receptor modulation, and long-duration plasticity effects analogous to LTP/LTD. Electrode placement follows 10-20 system coordinates for anatomical precision. Effects persist 60–90 minutes post-stimulation and consolidate with repeated sessions.
How It Is Used at Our Practice
Our tES protocols are designed from each patient's individual QEEG data to ensure accurate cortical targeting. We use tDCS with current and duration parameters matched to the clinical indication — motor recovery after stroke, cognitive function improvement, or pain modulation.
Each session is conducted in-clinic under direct supervision. A programme typically consists of 5–10 sessions over 2–3 weeks, with functional assessment before and after each treatment block.
Scientific Evidence
- Bikson M et al. 2016, Brain Stimul — Safety of transcranial direct current stimulation: evidence based update
- Nitsche MA & Paulus W 2000, J Physiol — Excitability changes induced in the human motor cortex by tDCS
- Brunoni AR et al. 2012, Int J Neuropsychopharmacol — tDCS studies in healthy adults and clinical populations
- Lefaucheur JP et al. 2017, Clin Neurophysiol — Evidence-based guidelines on tES for brain disorders
Frequently Asked Questions
- Is tES safe?
- Yes, when administered correctly by trained medical personnel. Reported side effects are mild and transient — typically skin redness at electrode sites or mild tingling.
- Which conditions can tES address?
- tES has been studied for post-stroke recovery, mild cognitive impairment, chronic pain, and mood disorders. Suitability for your condition is assessed during consultation.
- Are the effects permanent?
- tES effects are cumulative and can be maintained with structured neuroplasticity training programmes. Maintenance sessions may be recommended depending on the condition.
Wondering whether this modality is right for your condition?