The Time Course of Ineffective Sham Blinding During 1mA tDCS

Abstract

Background: Studies using transcranial direct current stimulation (tDCS) typically compare the effects of an active (10-30min) relative to a shorter sham (placebo) protocol. Both active and sham tDCS are presumed to be perceptually identical on the scalp, and thus represent an effective method of delivering double-blinded experimental designs. However, participants often show above-chance accuracy when asked which condition involved active/sham retrospectively. Objective/Hypothesis: We aimed to assess the time course of sham-blinding during active and sham tDCS. We predicted that 1) Participants will be aware that the current is switched on for a longer duration in the active versus the sham protocol, 2) Active anodal tDCS will reduce reaction times more effectively than sham. Methods: 32 adults were tested in a pre-registered, double-blinded, within-subjects design. A forced-choice reaction time task was undertaken before, during and after active (10min 1mA) and sham (20s 1mA) tDCS. The anode was placed over the left primary motor cortex (C3) to target the right hand, and the cathode on the right forehead. Two probe questions were asked every 30s: 'Is the stimulation on?' and 'How sure are you?'. Results: Distinct periods of non-overlapping confidence intervals were identified between the active and sham conditions, totalling 5min (57.1% of the total difference in stimulation time). These began immediately after sham ramp-down and lasted until the active protocol had ended. Active tDCS had no effect on reaction times compared to sham (��RT active vs sham p>0.38 in all blocks). Conclusions: We show a failure of placebo control during low-intensity tDCS.