Would the Use of Safe, Cost-Effective tDCS Tackle Rather than Cause Unfairness in Sports?
Neuromodulation technologies like transcranial direct current stimulation (tDCS) might enable professional and amateur athletes to reach their respective levels of physical excellence in a safe, cost-effective, and fair manner. Key factors that may assist an athlete in achieving their potential usually include training for many years, often since childhood, and access to a high level of funding. If cost-effective neuromodulation based on tDCS lives up to its promises (regarding safety and efficacy), tDCS can help athletes to learn relevant skills more effectively and thus reach their respective levels of physical excellence more quickly, especially athletes with limited time and resources. Whilst dangerous, illegal drugs such as EPO and steroids can increase performance without training, current evidence suggests that tDCS assists an athlete in improving their performance in combination with training. Given that the World Anti-Doping Association has not made any statement regarding the permissibility of tDCS, whilst access to and popularity of tDCS are constantly increasing, it is important to consider more in-depth if the use of tDCS can be justified. Here, we will outline three key criteria that any performance-enhancing measure must meet if its use can be considered ethical and permissible according to WADA requirements. tDCS must meet our requirements of safety, hard work from the athlete and accessibility. The preliminary evidence regarding its safety, its relatively low cost and the reasonable expectation, that long-term improvements can only be made if its application is paralleled by intense training, justifies its further research in the context of athletic performance enhancement. Moreover, we also consider its potential wider impact, especially how tDCS could help to level the playing field between amateur and elite athletes.
KeywordstDCS Sports Athletic performance Enhancement Ergogenic aid Doping
Compliance with Ethical Standards
Conflict of Interest
The first author obtained a reduced tDCS device ($200 discount) in June 2017 based on disclosing her scientific and athletic background with Halo Neuroscience. The other authors declare that there is no conflict of interest.
- Antal, A., Keeser, D., Priori, A., Padberg, F., & Nitsche, M. A. (2015). Conceptual and procedural shortcomings of the systematic review “evidence that transcranial direct current stimulation (tDCS) generates little-to-no reliable neurophysiologic effect beyond MEP amplitude modulation in healthy human subjects: a systematic review” by Horvath and co-workers. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation, 8(4), 846–849.CrossRefGoogle Scholar
- Chatzopoulos, I. (2009). The legal framework of doping: doping sanctions and their critique. International Quarterly of Sport Science, l. Google Scholar
- Consolvo, S., Everitt, K., Smith, I., & Landay, J. A. (2006). Design requirements for technologies that encourage physical activity. In Proceedings of the SIGCHI conference on Human Factors in computing systems (pp. 457–466). New York: ACM.Google Scholar
- David, P., (2005) Human rights in youth sport: a critical review of children’s rights in competitive sportsGoogle Scholar
- Epstein, D. (2014). The sports gene: Inside the science of extraordinary athletic performance. New York: Penguin.Google Scholar
- Hackney, A. C. (2017). Doping, performance-enhancing drugs, and hormones in sport: mechanisms of action and methods of detection. New York: Elsevier.Google Scholar
- Heuberger, J. A., Rotmans, J. I., Gal, P., Stuurman, F. E., van’t Westende, J., Post, T. E., et al. (2017). Effects of erythropoietin on cycling performance of well trained cyclists: a double-blind, randomised, placebo-controlled trial. The Lancet Haematology, 4(8), e374–e386.CrossRefPubMedGoogle Scholar
- Horvath, J. C., Forte, J. D., & Carter, O. (2015). Evidence that transcranial direct current stimulation (tDCS) generates little-to-no reliable neurophysiologic effect beyond MEP amplitude modulation in healthy human subjects: a systematic review. Neuropsychologia, 66, 213–236.CrossRefPubMedGoogle Scholar
- Lattari, E., Campos, C., Lamego, M. K., de Souza Passos, S. L., Neto, G. M., Rocha, N. B., et al. (2017). Can transcranial direct current stimulation improve muscle power in individuals with advanced resistance training experience?. Journal of Strength and Conditioning Research. https://doi.org/10.1519/JSC.0000000000001956.
- McMahon, D. (2018). UCI bans Sky’s motorhome RV from cycling and Tour de France - Business Insider. [Online]. Available: http://www.businessinsider.com/uci-bans-skys-motorhome-rv-from-cycling-and-tour-de-france-2015-6?IR=T. Accessed 18 Jun 2018.
- McNamee, M. J. (2012). The spirit of sport and the medicalisation of anti-doping: empirical and normative ethics. Asian Bioethics Review, 4(4), 374–392.Google Scholar
- Montenegro, R., Okano, A., Gurgel, J., Porto, F., Cunha, F., Massaferri, R., & Farinatti, P. (2015). Motor cortex tDCS does not improve strength performance in healthy subjects. Motriz: Revista de Educação Física, 21(2), 185–193.Google Scholar
- Mulhere, K. (2018). Olympic figure skating: how much it costs to compete | Money. [Online]. Available: http://time.com/money/5136679/olympic-figure-skating-costs/. Accessed 22 Aug 2018.
- Nitsche, M. A., Seeber, A., Frommann, K., Klein, C. C., Rochford, C., Nitsche, M. S., et al. (2005). Modulating parameters of excitability during and after transcranial direct current stimulation of the human motor cortex. The Journal of Physiology, 568(1), 291–303.CrossRefPubMedPubMedCentralGoogle Scholar
- Parry, J. (2018). E-sports are Not Sports. Sport, Ethics and Philosophy, 1–16. https://doi.org/10.1080/17511321.2018.1489419.
- von Rein, E., Hoff, M., Kaminski, E., Sehm, B., Steele, C. J., Villringer, A., & Ragert, P. (2015). Improving motor performance without training: the effect of combining mirror visual feedback with transcranial direct current stimulation. Journal of Neurophysiology, 113(7), 2383–2389.CrossRefGoogle Scholar
- Reis, J., Schambra, H. M., Cohen, L. G., Buch, E. R., Fritsch, B., Zarahn, E., et al. (2009). Noninvasive cortical stimulation enhances motor skill acquisition over multiple days through an effect on consolidation. Proceedings of the National Academy of Sciences, 106(5), 1590–1595.CrossRefGoogle Scholar
- Robertson, J. (2018). The 2018 Winter Olympics are already tainted - The New York Times. [Online]. Available: https://www.nytimes.com/2017/12/27/opinion/2018-winter-olympics-russia.html. Accessed 18 Jun 2018.
- Scott, M. (2018). Olympics: North Korea’s Kim Jong-su loses medals after positive drugs test | Sport | The Guardian. [Online]. Available: https://www.theguardian.com/sport/2008/aug/15/olympics2008.drugsinsport. Accessed 25 Jun 2018.
- Starkey, N. (2018). Tyson Gay ban: what is oxilofrine? | Sport | The Guardian. [Online]. Available: https://www.theguardian.com/sport/2013/jul/15/tyson-gay-asafa-powell-oxilofrine. Accessed 18 Jun 2018.
- Union Cycliste Internationale (UCI) (2018). Regulations. [Online]. Available: http://www.uci.org/inside-uci/constitutions-regulations/regulations. Accessed 30 Sep 2018.
- Vargas, V. Z., Baptista, A. F., Pereira, G. O., Pochini, A. C., Ejnisman, B., Santos, M. B., et al. (2018). Modulation of isometric quadriceps strength in soccer players with transcranial direct current stimulation: a crossover study. The Journal of Strength & Conditioning Research, 32(5), 1336–1341.CrossRefGoogle Scholar
- Waters-Metenier, S., Husain, M., Wiestler, T., & Diedrichsen, J. (2014). Bihemispheric transcranial direct current stimulation enhances effector-independent representations of motor synergy and sequence learning. The Journal of Neuroscience, 34(3), 1037–1050.CrossRefPubMedPubMedCentralGoogle Scholar
- Williams, P. S., Hoffman, R. L., and Clark, B. C., (2013) “Preliminary evidence that anodal transcranial direct current stimulation enhances time to task failure of a sustained submaximal contraction”. PLoS One, vol. 8, no. 12Google Scholar
- World Anti-Doping Agency (WADA) (2015). World Anti-Doping Code. Montreal. www.wada-ama.org/code.
- World Anti-Doping Agency (WADA) (2016). The World Anti-Doping Code: International Standard. Prohibited List January 2017.Google Scholar
- Worldometers (2017). World population clock. Worldometers. [Online]. Available: http://www.worldometers.info/.