Safety and Acute Effects of tDCS on Musical Performance in Adolescent Musicians

This randomized parallel-group pilot study will evaluate the safety, tolerability, and acute effects of transcranial direct current stimulation (tDCS) in adolescent musicians aged 12 to 16 years, including both instrumentalists and singers.

Twenty-four participants will be allocated in a 1:1 ratio to active or sham stimulation. Active tDCS will be delivered in a single session at 2.0 mA for 30 minutes using 5 × 7 cm electrodes, with the anode positioned over FCz and the cathode over Fp2. The sham condition will use the same electrode montage and will reproduce the initial sensations associated with stimulation without sustained current.

Participants will perform the same previously learned musical piece or excerpt at baseline, immediately after stimulation, and approximately two hours after stimulation. Performances will be audiovisually recorded, pseudonymized, randomized, and evaluated by blinded expert raters using a standardized music performance rubric. Safety and tolerability will be assessed throughout the session and during follow-up using a structured symptom checklist and predefined stopping criteria.

Participants will also provide brief 0-10 ratings of nervousness, confidence, and self-perceived musical performance. These measures are exploratory and are not intended for psychological diagnosis. The study will additionally assess the effectiveness of blinding and the feasibility of conducting a controlled tDCS protocol in adolescent musicians.

Written informed consent from a legal guardian and written assent from the adolescent will be obtained before any study procedure. Participation is voluntary and will not influence grades, artistic selection, scholarships, or continued participation in any musical program.

Inclusion criteria

• Age 12 to 16 years, inclusive, at the time of enrollment.
• Regular participation in instrumental or vocal music training for at least 12 months.
• Ability to safely perform a previously learned musical piece or excerpt lasting approximately 1 to 2 minutes.
• General health status compatible with participation, confirmed through a pre-session safety screening.
• No known neurological or clinical condition considered to increase the risk associated with stimulation.
• No current use of medication or substances considered by the study team to substantially alter cortical excitability or increase procedural risk.
• Written informed consent from a legal guardian.
• Written assent from the adolescent and voluntary willingness to participate.

Exclusion criteria

• History of epilepsy or non-febrile seizures.
• Relevant brain injury, previous cranial surgery, or other neurological condition considered incompatible with the protocol.
• Pacemaker, implanted electronic device, neurostimulator, or cranial metallic implant that could pose a risk or interfere with stimulation.
• Current use of anticonvulsant medication or other medication considered by the study team to represent a contraindication or unacceptable precaution.
• Previous experience with tDCS when such experience could compromise blinding.
• Dermatitis, wounds, infection, burns, significant pain, or other scalp abnormalities at the planned electrode sites.
• Known or suspected pregnancy, as a precaution; pregnancy testing will not be performed as part of the study.
• Acute illness or relevant symptoms on the day of the session, including fever, significant headache, persistent dizziness, or relevant sleep deprivation, when these findings justify postponement or exclusion for safety reasons.