CNS Non-invasive Brain Stimulation

  • Mirret M. El-Hagrassy
  • Felipe Jones
  • Gleysson Rosa
  • Felipe Fregni


Non-invasive brain stimulation (NIBS) refers to brain activity modulation without invasive maneuvers. In this chapter, we discuss the two main NIBS techniques, transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). We explain the basic principles behind these two techniques, and the available data on their safety and effectiveness. We also discuss some of their main clinical applications in the adult and pediatric populations, providing a deeper view of their effects as well as the unique challenges of research in this field.

In the adult subsection, we discuss the use of repetitive TMS (rTMS), deep TMS (DTMS) and tDCS in depression, as well rTMS and tDCS in neuropathic pain. In the pediatric subsection, we discuss the use of tDCS and rTMS in epilepsy and cerebral palsy. We conclude that TMS and tDCS tend to be well tolerated in adult and pediatric populations overall; however, caution should be applied when using rTMS in pediatric populations, where long-term data is limited. NIBS has the potential to safely improve neuroplasticity and to treat multiple neurologic disorders, particularly when added to rehabilitative therapy.


Non-invasive brain stimulation Transcranial magnetic stimulation Transcranial direct current stimulation Safety Clinical applications EEG Depression Neuropathic pain Epilepsy Cerebral Palsy 



Attention deficit hyperactivity disorder


Antiepileptic drug


α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid


Before Common Era


Brain-scalp distance


Cerebral palsy


Continuous spikes and waves during slow wave sleep


Dorsolateral prefrontal cortex


Deep transcranial magnetic stimulation


Electroconvulsive therapy




Epidural motor cortex stimulation


Epilepsia partialis continua


Functional magnetic resonance imaging


Gamma-aminobutyric acid


Hamilton Scale for Depression


High-Definition transcranial direct current stimulation


Intracortical inhibition


Left dorsolateral prefrontal cortex


Long-term depression


Long-term potentiation


Primary motor cortex


Montgomery Åsberg Depression Rating Scale


Major depressive disorder


Metabotropic glutamate receptors


Number of subjects in study


Non-invasive brain stimulation




Number needed to treat


Neuropathic pain


Prefrontal cortex


Paired-pulse transcranial magnetic stimulation


Right dorsolateral prefrontal cortex


Rasmussen’s encephalitis


Repetitive transcranial magnetic stimulation




Single-photon emission computed tomography


Single-pulse transcranial magnetic stimulation


Sudden unexpected death in epilepsy


Transcranial direct current stimulation


Transcranial electric stimulation


Transcranial magnetic stimulation


Voltage-gated calcium channels



The authors would like to acknowledge Anthony T. O’Brien, MD for assistance with references.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Mirret M. El-Hagrassy
    • 1
  • Felipe Jones
    • 1
  • Gleysson Rosa
    • 1
  • Felipe Fregni
    • 1
  1. 1.Spaulding Neuromodulation Center, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General HospitalCharlestownUSA

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