Low intensity transcranial electrical stimulation (TES) in humans, encompassing transcranial direct current (tDCS), transcutaneous spinal Direct Current Stimulation (tsDCS), transcranial alternating current (tACS), and transcranial random noise (tRNS) stimulation or their combinations, appears to be safe. No serious adverse events (SAEs) have been reported so far in over 18,000 sessions administered to healthy subjects, neurological and psychiatric patients, as summarized here. Moderate adverse events (AEs), as defined by the necessity to intervene, are rare, and include skin burns with tDCS due to suboptimal electrode-skin contact. Very rarely mania or hypomania was induced in patients with depression (11 documented cases), yet a causal relationship is difficult to prove because of the low incidence rate and limited numbers of subjects in controlled trials. Mild AEs (MAEs) include headache and fatigue following stimulation as well as prickling and burning sensations occurring during tDCS at peak-to-baseline intensities of 1-2mA and during tACS at higher peak-to-peak intensities above 2mA. The prevalence of published AEs is different in studies specifically assessing AEs vs. those not assessing them, being higher in the former. AEs are frequently reported by individuals receiving placebo stimulation. The profile of AEs in terms of frequency, magnitude and type is comparable in healthy and clinical populations, and this is also the case for more vulnerable populations, such as children, elderly persons, or pregnant women. Combined interventions (e.g., co-application of drugs, electrophysiological measurements, neuroimaging) were not associated with further safety issues. Safety is established for low-intensity 'conventional' TES defined as <4mA, up to 60min duration per day. Animal studies and modeling evidence indicate that brain injury could occur at predicted current densities in the brain of 6.3-13A/m2 that are over an order of magnitude above those produced by tDCS in humans. Using AC stimulation fewer AEs were reported compared to DC. In specific paradigms with amplitudes of up to 10mA, frequencies in the kHz range appear to be safe. In this paper we provide structured interviews and recommend their use in future controlled studies, in particular when trying to extend the parameters applied. We also discuss recent regulatory issues, reporting practices and ethical issues. These recommendations achieved consensus in a meeting, which took place in Göttingen, Germany, on September 6-7, 2016 and were refined thereafter by email correspondence.

Pianists often report that pure listening to a well-trained piece of music can involuntarily trigger the respective finger movements. We designed a magnetoencephalography (MEG) experiment to compare the motor activation in pianists and nonpianists while listening to piano pieces. For pianists, we found a statistically significant increase of activity above the region of the contralateral motor cortex. Brain surface current density (BSCD) reconstructions revealed a spatial dissociation of this activity between notes preferably played by the thumb and the little finger according to the motor homunculus. Hence, we could demonstrate that pianists, when listening to well-trained piano music, exhibit involuntary motor activity involving the contralateral primary motor cortex (M1).

Modeling in magnetoencephalography (MEG) and electroencephalography (EEG) requires knowledge of the in vivo tissue resistivities of the head. The aim of this paper is to examine the influence of tissue resistivity changes on the neuromagnetic field and the electric scalp potential. A high-resolution finite element method (FEM) model (452,162 elements, 2-mm resolution) of the human head with 13 different tissue types is employed for this purpose. Our main finding was that the magnetic fields are sensitive to changes in the tissue resistivity in the vicinity of the source. In comparison, the electric surface potentials are sensitive to changes in the tissue resistivity in the vicinity of the source and in the vicinity of the position of the electrodes. The magnitude (strength) of magnetic fields and electric surface potentials is strongly influenced by tissue resistivity changes, while the topography is not as strongly influenced. Therefore, an accurate modeling of magnetic field and electric potential strength requires accurate knowledge of tissue resistivities, while for source localization procedures this knowledge might not be a necessity.