Home use of low-intensity transcranial electrical stimulation in clinical practice: an IFCN handbook chapter

Non-invasive brain stimulation (NIBS) includes a growing set of techniques aimed at modulating brain activity without surgery or implants. Transcranial magnetic (TMS) and electrical stimulation (tES) are among the most established methods. tES delivers low-intensity current via scalp electrodes, offering a cheaper and portable option, especially for home-based use. Clinical evidence suggests that the effects of tES are cumulative with consecutive applications needed to achieve meaningful changes. The therapeutic application of the clinic-based tES usually involves a minimum of two weeks of daily visits to the clinical institute, which poses a large burden and stress on patients. Home-based tES, e.g. under remote supervision (RS-tES), following adequate training by trained professionals paves the path to increasing the accessibility of the technology to patients. In 2025, the US FDA approved the first home-based tDCS system for the treatment of "moderate to severe major depressive disorder in the current episode, either as monotherapy or as an adjunctive treatment, in patients 18 years and older who are not considered treatment refractory to medication. In this work, the latest knowledge related to home-use of tES is introduced, including the methodology, most frequent clinical applications, advances and limitations.