Effects of anodal transcranial direct current stimulation on athletic performance among elite athletes: A systematic review and meta-analysis

Clinical Snapshot

Key Findings

• P Value: p < 0.01

• Effect Size: SMD = 0.57 (moderate effect)

• Primary Outcome: Overall athletic performance improvement

• Nnt Or Sensitivity: Domain-specific effects: sport-specific performance (SMD = 0.79), physical fitness (SMD = 0.58), recovery (SMD = 0.17, non-significant)

• Confidence Interval: 95% CI [0.39, 0.75]

Clinical Application

Requires specialized equipment and trained personnel; limited by moderate heterogeneity in responses Would require TGA consideration for therapeutic use; potential application in Australian Institute of Sport programs and elite sporting academies Elite athletes seeking performance enhancement in sport-specific skills and physical fitness

Abstract

BACKGROUND: Non-invasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS), have been proposed as promising approaches for enhancing motor performance. However, evidence regarding their effects on different domains of athletic performance in elite athletes remains inconclusive. OBJECTIVE: This study aims to quantify the effects of anodal tDCS on athletic performance in elite athletes, compared with a sham condition. METHODS: A comprehensive search of six electronic databases (PubMed, Web of Science, SportDiscus, ECSCO, Embase, and the Cochrane Library) was conducted to identify randomized clinical trials (RCTs). Standardized mean differences (SMDs) based on post-intervention scores were pooled using random-effects models to estimate pooled effect sizes. Subgroup analyses were performed to examine potential moderating variables. Study quality and risk of bias were evaluated using the Cochrane Risk of Bias Tool. RESULTS: A total of 18 studies involving 259 elite athletes were included in the analysis. The results indicated that anodal tDCS had a moderate but significant overall effect on athletic performance in elite athletes (SMD = 0.57, 95% CI [0.39, 0.75], p < 0.01), although moderate heterogeneity was observed ( I²= 51.38%). Subgroup analyses revealed significant domain-specific variability: the effects were strongest in sport-specific performance (SMD = 0.79, 95% CI [0.51, 1.08], p < 0.01) and physical fitness (SMD = 0.58, p < 0.01), whereas the effects on recovery (SMD = 0.17, p = 0.65) and psychological variables (SMD = 0.38, p = 0.09) were negligible and non-significant. Additionally, the M1 area was found to be the most effective cortical target. CONCLUSIONS: Our findings provide evidence that anodal tDCS is a promising tool for enhancing performance in elite athletes, but its effectiveness is highly domain-dependent. It is particularly potent for improving sport-specific skills and physical fitness, while its role in accelerating recovery remains unsupported. Coaches and practitioners should consider these domain-specific variations and the ceiling effect of elite populations when designing tDCS interventions.

References

1. 1.Pan, Y., Zhang, M., Chen, Y., Xie, C., & Wang, K. (2026). Effects of anodal transcranial direct current stimulation on athletic performance among elite athletes: A systematic review and meta-analysis. Behavioural Brain Research, 116193. https://doi.org/10.1016/j.bbr.2026.116193