Effect of Transcranial Direct Current Stimulation in Acute Anxiety and Cognitive Performance of Athletes: an Experimental, Double-Blind, Randomized Study




Anxiety is present at various times of sports competitions sometimes limiting the athletes’ performance. The objective of this study was to evaluate the effect of transcranial direct current stimulation (tDCS) on athletes' acute anxiety symptoms and cognitive performance when applied for 7 days. This is an experimental, double-blind, randomized study of 23 soccer players with anxiety symptoms. Two groups: anodic tDCS and sham tDCS. Anodic stimulation was performed in the left dorsolateral prefrontal cortex (DLPFC) and the cathode positioned in the right DLPFC, current intensity 2 mA, for 20 minutes on 7 consecutive days and then on the 14th day. Anxiety was assessed by the HAM-A scale and cognitive performance was through the Stroop Color Word Test and the Trail Making Test. For statistical analysis, t-student test and Spearman's correlation coefficient were used. Statistical significance was set at p <0.05. No significant differences were observed between the groups in decreasing anxiety symptoms and improving cognitive performance using a 7-day consecutive protocol. This study provides evidence that there is an inverse correlation between anxiety and inhibitory control. There was no difference in the application of tDCS compared to the control group regarding improvement in anxious symptoms and inhibitory control in this specific population using a seven-day tDCS protocol.

Keywords: Anxiety. Transcranial Direct Current Stimulation. Executive Function. Athletes. Cognition.


A ansiedade está presente em diversos momentos das competições esportivas limitando por vezes o desempenho dos atletas. O objetivo do estudo foi avaliar o efeito da estimulação transcraniana por corrente contínua (ETCC) nos sintomas agudos de ansiedade e no desempenho cognitivo de atletas quando aplicada por 7 dias. Este é um estudo experimental, duplo-cego e randomizado com 23 jogadores de futebol com

sintomas de ansiedade. Dois grupos: ETCC anódica e ETCC simulada. A estimulação anódica foi realizada no córtex pré-frontal dorsolateral esquerdo (DLPFC) e o cátodo posicionado no DLPFC direito, intensidade de corrente 2 mA, por 20 minutos em 7 dias consecutivos e depois no 14º dia. A ansiedade foi avaliada pela escala HAM-A e o desempenho cognitivo por meio do Stroop Color Word Test e do Trail Making Test. Para análise estatística foram utilizados o teste t-student e o coeficiente de correlação de Spearman. A significância estatística foi fixada em p<0,05. Não foram observadas diferenças significativas entre os grupos na diminuição dos sintomas de ansiedade e na melhoria do desempenho cognitivo usando um protocolo de 7 dias consecutivos. Este estudo fornece evidências de que existe uma correlação inversa entre ansiedade e controle inibitório. Não houve diferença na aplicação da ETCC em comparação ao grupo controle quanto à melhora dos sintomas ansiosos e ao controle inibitório nesta população específica utilizando um protocolo de ETCC de sete dias.

Palavras-chaves: Ansiedade. Estimulação Transcraniana por Corrente Contínua. Função Executiva. Atletas. Cognição.


Dias C. Do stress e ansiedade às emoções no desporto: Da importância da sua compreensão à necessidade da sua gestão. Acta Cir Bras. 2005;17.

Craske MG, Rauch SL, Ursano R, Prenoveau J, Pine DS, Zinbarg RE. What is an anxiety disorder? Depress Anxiety. 2009;26(12):1066–85.

Mann DTY, Williams AM, Ward P, Janelle CM. Perceptual-Cognitive Expertise in Sport?: A Meta-Analysis. J Sport Exerc Psychol. 2007;29:457–78.

Davidson RJ, Pizzagalli D, Nitschke JB, Putnam K. Depression: Perspectives from Affective Neuroscience. Annu Rev Psychol. 2002;53:545–74.

Borducchi DMM, Gomes JS, Akiba H, Cordeiro Q, Borducchi JHM, Valentin LSS, et al. Transcranial Direct Current Stimulation Effects on Athletes’ Cognitive Performance: An Exploratory Proof of Concept Trial. Front Psychiatry. 2016;7(November):1–5.

Lévesque J, Eugène F, Joanette Y, Paquette V, Mensour B, Beaudoin G, et al. Neural circuitry underlying voluntary suppression of sadness. Biol Psychiatry. 2003;53(6):502–10.

Brunoni AR, Nitsche MA, Bolognini N, Bikson M, Wagner T, Merabet L, et al. Clinical research with transcranial direct current stimulation (tDCS): Challenges and future directions. Brain Stimul. 2012;5(3):175–95.

Kummer A, Cardoso F, Teixeira AL. Generalized anxiety disorder and the Hamilton Anxiety Rating Scale in Parkinson’s disease. Arq Neuropsiquiatr. 2010;68(4):495–501.

Troyer AK, Leach L, Strauss E. Aging and response inhibition: Normative data for the Victoria Stroop Test. Aging, Neuropsychol Cogn. 2006;13(1):20–35.

Perianez JA, Rios-Lago M, Rodriguez-Sanchez JM, Adrover-Roig D, Sanchez-Cubillo I, Crespo-Facorro B, et al. Trail Making Test in traumatic brain injury, schizophrenia, and normal ageing: Sample comparisons and normative data. Arch Clin Neuropsychol. 2007;22(4):433–47.

Montiel JM, Seabra AG. Teste de Trilhas: Partes A e B. In: Seabra AG, Dias NM. Avaliação neuropsicológica cognitiva: atenção e funções executivas. 1. São Paulo: Memnon; 2012. p. 79–85.

Brunoni AR, Ferrucci R, Bortolomasi M, Vergari M, Tadini L, Boggio PS, et al. Transcranial direct current stimulation (tDCS) in unipolar vs. bipolar depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2011;35(1):96–101.

Nitsche MA, Bikson M. Extending the parameter range for tDCS: Safety and tolerability of 4 mA stimulation. Brain Stimul. 2017;10(3):541–2.

Hepsomali P, Hadwin JA, Liversedge SP, Degno F, Garner M. The impact of cognitive load on processing efficiency and performance effectiveness in anxiety: evidence from event-related potentials and pupillary responses. Exp Brain Res. 2019;1-13.

Rice SM, Purcell R, De Silva S, Mawren D, McGorry PD, Parker AG. The Mental Health of Elite Athletes: A Narrative Systematic Review. Sport Med. 2016;46(9):1333–53.

Vicario CM, Salehinejad MA, Felmingham K, Martino G, Nitsche MA. A systematic review on the therapeutic effectiveness of non-invasive brain stimulation for the treatment of anxiety disorders. Neurosci Biobehav Rev. 2019;96:219–31.

Palm U, Kirsch V, Kübler H, Sarubin N, Keeser D, Padberg F, et al. Transcranial direct current stimulation (tDCS) for treatment of phobic postural vertigo: an open-label pilot study. Eur Arch Psychiatry Clin Neurosci. 2018;1–4.

Philippot P, De Raedt R, Vanderhasselt M-A, Heeren A, Maurage P, Billieux J, et al. Impact of transcranial direct current stimulation on attentional bias for threat: a proof-of-concept study among individuals with social anxiety disorder. Soc Cogn Affect Neurosci. 2016;12(2):251–60.

Yang X, Zhang Y, Wang C, Hou Z, Yuan Y, Liu X, et al. Increased interhemispheric synchrony underlying the improved athletic performance of rowing athletes by transcranial direct current stimulation. Brain Imaging Behav. 2018;1-9.

Zandonai T, Holgado D, Zabala M, Sanabria D, Ciria LF, Hopker J. Transcranial direct current stimulation (tDCS) over the left prefrontal cortex does not affect time-trial self-paced cycling performance: Evidence from oscillatory brain activity and power output. PLoS One. 2019;14(2):e0210873.

Medina J, Cason S. No evidential value in samples of transcranial direct current stimulation (tDCS) studies of cognition and working memory in healthy populations. Cortex. 2017;94:131–41.

Horvath JC, Forte JD, Carter O. Quantitative review finds no evidence of cognitive effects in healthy populations from single-session transcranial direct current stimulation (tDCS). Brain Stimul. 2015;8(3):535–50.

Brunoni AR, Vanderhasselt M-A. Working memory improvement with non-invasive brain stimulation of the dorsolateral prefrontal cortex: A systematic review and meta-analysis. Brain Cogn. 2014;86:1–9.

Suntrup S, Teismann I, Wollbrink A, Winkels M, Warnecke T, Flöel A, et al. Magnetoencephalographic evidence for the modulation of cortical swallowing processing by transcranial direct current stimulation. Neuroimage. 2013;83:346–54.

Gill J, Shah-Basak PP, Hamilton R. It’s the thought that counts: Examining the task-dependent effects of transcranial direct current stimulation on executive function. Brain Stimul. 2015;8(2):253–9.

Wu YJ, Tseng P, Chang CF, Pai MC, Hsu K Sen, Lin CC, et al. Modulating the interference effect on spatial working memory by applying transcranial direct current stimulation over the right dorsolateral prefrontal cortex. Brain Cogn. 2014;91:87–94.

Hogeveen J, Grafman J, Aboseria M, David A, Bikson M, Hauner KK. Effects of High-Definition and Conventional tDCS on Response Inhibition. Brain Stimul. 2016;9(5):720–9.

Jeon SY, Han SJ. Improvement of the working memory and naming by transcranial direct current stimulation. Ann Rehabil Med. 2012;36(5):585–95.

Loftus AM, Yalcin O, Baughman FD, Vanman EJ, Hagger MS. The impact of transcranial direct current stimulation on inhibitory control in young adults. Brain Behav. 2015;5(5):1–9.

Li LM, Uehara K, Hanakawa T. The contribution of interindividual factors to variability of response in transcranial direct current stimulation studies. Front Cell Neurosci. 2015;9:181.

Plewnia C, Zwissler B, Längst I, Maurer B, Giel K, Krüger R. Effects of transcranial direct current stimulation (tDCS) on executive functions: Influence of COMT Val/Met polymorphism. Cortex. 2013;49(7):1801–7.

Basanovic J, Notebaert L, Clarke PJF, MacLeod C, Jawinski P, Chen NTM. Inhibitory attentional control in anxiety: Manipulating cognitive load in an antisaccade task. PLoS One. 2018;13(10):1–16.

Eysenck MW, Derakshan N, Santos R, Calvo MG. Anxiety and cognitive performance: Attentional control theory. Emotion. 2007;7(2):336–53.

Beaudreau SA, MacKay-Brandt A, Reynolds J. Application of a cognitive neuroscience perspective of cognitive control to late-life anxiety. J Anxiety Disord. 2013;27(6):559–66.



Como Citar

Oliveira RV de, Moura HS de, Sousa JO de, Trevisol FS, Trevisol DJ. Effect of Transcranial Direct Current Stimulation in Acute Anxiety and Cognitive Performance of Athletes: an Experimental, Double-Blind, Randomized Study. J. Health Sci. [Internet]. 3º de julho de 2024 [citado 13º de julho de 2024];26(2):106-14. Disponível em: https://journalhealthscience.pgsscogna.com.br/JHealthSci/article/view/12023