Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter October 31, 2022

A systematic review of transcranial direct current stimulation on eye movements and associated psychological function

  • Ashwin Subramaniam , Sicong Liu , Liam Lochhead and Lawrence Gregory Appelbaum ORCID logo EMAIL logo


The last decades have seen a rise in the use of transcranial direct current stimulation (tDCS) approaches to modulate brain activity and associated behavior. Concurrently, eye tracking (ET) technology has improved to allow more precise quantitative measurement of gaze behavior, offering a window into the mechanisms of vision and cognition. When combined, tDCS and ET provide a powerful system to probe brain function and measure the impact on visual function, leading to an increasing number of studies that utilize these techniques together. The current pre-registered, systematic review seeks to describe the literature that integrates these approaches with the goal of changing brain activity with tDCS and measuring associated changes in eye movements with ET. The literature search identified 26 articles that combined ET and tDCS in a probe-and-measure model and are systematically reviewed here. All studies implemented controlled interventional designs to address topics related to oculomotor control, cognitive processing, emotion regulation, or cravings in healthy volunteers and patient populations. Across these studies, active stimulation typically led to changes in the number, duration, and timing of fixations compared to control stimulation. Notably, half the studies addressed emotion regulation, each showing hypothesized effects of tDCS on ET metrics, while tDCS targeting the frontal cortex was widely used and also generally produced expected modulation of ET. This review reveals promising evidence of the impact of tDCS on eye movements and associated psychological function, offering a framework for effective designs with recommendations for future studies.

Corresponding author: Lawrence Gregory Appelbaum, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC 27710, USA; and Department of Psychiatry, University of California, 106 Guava Hall, 9500 Gillman Dr, San Diego, CA 92093, USA, E-mail:

Funding source: Army Research Office

Award Identifier / Grant number: W911NF-15-1-0390


The authors would like to thank Elly Daskalakis for her valuable comments on this manuscript.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This research was funded by grant support to L.G.A. through the United States Army Research Office [W911NF-15-1-0390].

  3. Conflict of interest statement: All authors declare that they have no conflict of interest related to the research presented in this article.


Allaert, J., De Raedt, R., Sanchez-Lopez, A., Baeken, C., and Vanderhasselt, M.A. (2020). Mind the social feedback: effects of tDCS applied to the left DLPFC on psychophysiological responses during the anticipation and reception of social evaluations. Soc. Cognit. Affect Neurosci. 17: 131–141, in Google Scholar PubMed PubMed Central

Allaert, J., Erdogan, M., Sanchez-Lopez, A., Baeken, C., De Raedt, R., and Vanderhasselt, M.A. (2021). Prefrontal tDCS attenuates self-referential attentional deployment: a mechanism underlying adaptive emotional reactivity to social-evaluative threat. Front. Hum. Neurosci. 15: 700557, in Google Scholar PubMed PubMed Central

Allaert, J., Sanchez-Lopez, A., De Raedt, R., Baeken, C., and Vanderhasselt, M.A. (2019). Inverse effects of tDCS over the left versus right DLPC on emotional processing: a pupillometry study. PLoS One 14: e0218327, in Google Scholar PubMed PubMed Central

Baddeley, A. (2007). Working memory, thought, and action. OUP, Oxford.10.1093/acprof:oso/9780198528012.001.0001Search in Google Scholar

Bhattacharya, A., Mrudula, K., Sreepada, S.S., Sathyaprabha, T.N., Pal, P.K., Chen, R., and Udupa, K. (2022). An overview of noninvasive brain stimulation: basic principles and clinical applications. Can. J. Neurol. Sci. 49: 479–492, in Google Scholar PubMed

Binney, R.J., Ashaie, S.A., Zuckerman, B.M., Hung, J., and Reilly, J. (2018). Frontotemporal stimulation modulates semantically-guided visual search during confrontation naming: a combined tDCS and eye tracking investigation. Brain Lang. 180–182: 14–23, in Google Scholar PubMed PubMed Central

Brunoni, A.R. and Vanderhasselt, M.A. (2014). Working memory improvement with non-invasive brain stimulation of the dorsolateral prefrontal cortex: a systematic review and meta-analysis. Brain Cognit. 86: 1–9, in Google Scholar PubMed

Buch, E.R., Santarnecchi, E., Antal, A., Born, J., Celnik, P.A., Classen, J., Gerloff, C., Hallett, M., Hummel, F.C., Nitsche, M.A., et al.. (2017). Effects of tDCS on motor learning and memory formation: a consensus and critical position paper. Clin. Neurophysiol. 128: 589–603, in Google Scholar PubMed

Carter, R.M. and Huettel, S.A. (2013). A nexus model of the temporal-parietal junction. Trends Cognit. Sci. 17: 328–336, in Google Scholar PubMed PubMed Central

Cavallo, A., Lungu, O., Becchio, C., Ansuini, C., Rustichini, A., and Fadiga, L. (2015). When gaze opens the channel for communication: integrative role of IFG and MPFC. Neuroimage 119: 63–69, in Google Scholar PubMed

Chen, G., Zhu, Z., He, Q., and Fang, F. (2021). Offline transcranial direct current stimulation improves the ability to perceive crowded targets. J. Vis. 21: 1, in Google Scholar PubMed PubMed Central

Chen, N.T.M., Basanovic, J., Notebaert, L., MacLeod, C., and Clarke, P.J.F. (2017). Attentional bias mediates the effect of neurostimulation on emotional vulnerability. J. Psychiatr. Res. 93: 12–19, in Google Scholar PubMed

Chen, P.L. and Machado, L. (2017). Developing clinically practical transcranial direct current stimulation protocols to improve saccadic eye movement control. J Eye Mov Res 10: 1–13, in Google Scholar PubMed PubMed Central

Ciullo, V., Spalletta, G., Caltagirone, C., Banaj, N., Vecchio, D., and Piras, F. (2021). Transcranial direct current stimulation and cognition in neuropsychiatric disorders: systematic review of the evidence and future directions. Neuroscientist 27: 285–309, in Google Scholar PubMed

Cox, M.L., Deng, Z.D., Palmer, H., Watts, A., Beynel, L., Young, J.R., Lisanby, S.H., Migaly, J., and Appelbaum, L.G. (2020). Utilizing transcranial direct current stimulation to enhance laparoscopic technical skills training: a randomized controlled trial. Brain Stimul. 13: 863–872, in Google Scholar PubMed PubMed Central

Diana, L., Pilastro, P., Aiello, E.N., Eberhard-Moscicka, A.K., Müri, R.M., and Bolognini, N. (2021). Saccades, attentional orienting and disengagement: the effects of anodal tDCS over right posterior parietal cortex (PPC) and frontal eye field (FEF). In: ACM symposium on eye tracking research and applications. Virtual event. Germany: Association for Computing Machinery.10.1145/3448018.3457995Search in Google Scholar

Eisenberger, N.I., Lieberman, M.D., and Williams, K.D. (2003). Does rejection hurt? An FMRI study of social exclusion. Science 302: 290–292, in Google Scholar PubMed

Esposito, M., Ferrari, C., Fracassi, C., Miniussi, C., and Brignani, D. (2022). Responsiveness to left-prefrontal tDCS varies according to arousal levels. Eur. J. Neurosci. 55: 762–777, in Google Scholar PubMed PubMed Central

Ettinger, U., Ffytche, D.H., Kumari, V., Kathmann, N., Reuter, B., Zelaya, F., and Williams, S.C. (2008). Decomposing the neural correlates of antisaccade eye movements using event-related FMRI. Cerebr. Cortex 18: 1148–1159, in Google Scholar PubMed

Fertonani, A. and Miniussi, C. (2017). Transcranial electrical stimulation: what we know and do not know about mechanisms. Neuroscientist 23: 109–123, in Google Scholar PubMed PubMed Central

Filmer, H.L., Fox, A., and Dux, P.E. (2019). Causal evidence of right temporal parietal junction involvement in implicit theory of mind processing. Neuroimage 196: 329–336, in Google Scholar PubMed

Fonteneau, C., Mondino, M., Arns, M., Baeken, C., Bikson, M., Brunoni, A.R., Burke, M.J., Neuvonen, T., Padberg, F., Pascual-Leone, A., et al.. (2019). Sham tDCS: a hidden source of variability? Reflections for further blinded, controlled trials. Brain Stimul. 12: 668–673, in Google Scholar PubMed

Fregni, F., Orsati, F., Pedrosa, W., Fecteau, S., Tome, F.A., Nitsche, M.A., Mecca, T., Macedo, E.C., Pascual-Leone, A., and Boggio, P.S. (2008). Transcranial direct current stimulation of the prefrontal cortex modulates the desire for specific foods. Appetite 51: 34–41, in Google Scholar PubMed PubMed Central

Guitton, D., Buchtel, H.A., and Douglas, R.M. (1985). Frontal lobe lesions in man cause difficulties in suppressing reflexive glances and in generating goal-directed saccades. Exp. Brain Res. 58: 455–472, in Google Scholar PubMed

Hayhoe, M. and Ballard, D. (2005). Eye movements in natural behavior. Trends Cognit. Sci. 9: 188–194, in Google Scholar PubMed

He, Z., Lin, Y., Xia, L., Liu, Z., Zhang, D., and Elliott, R. (2018). Critical role of the right VLPFC in emotional regulation of social exclusion: a tDCS study. Soc. Cognit. Affect Neurosci. 13: 357–366, in Google Scholar PubMed PubMed Central

He, Z., Liu, Z., Zhao, J., Elliott, R., and Zhang, D. (2019). Improving emotion regulation of social exclusion in depression-prone individuals: a tDCS study targeting right VLPFC. Psychol. Med. 50: 2768–2779, in Google Scholar

Heeren, A., Baeken, C., Vanderhasselt, M.A., Philippot, P., and de Raedt, R. (2015). Impact of anodal and cathodal transcranial direct current stimulation over the left dorsolateral prefrontal cortex during attention bias modification: an eye-tracking study. PLoS One 10: e0124182, in Google Scholar PubMed PubMed Central

Heinze, K., Ruh, N., Nitschke, K., Reis, J., Fritsch, B., Unterrainer, J.M., Rahm, B., Weiller, C., and Kaller, C.P. (2014). Transcranial direct current stimulation over left and right DLPFC: lateralized effects on planning performance and related eye movements. Biol. Psychol. 102: 130–140, in Google Scholar PubMed

Holmqvist, K., Nyström, M., Andersson, R., Dewhurst, R., Jarodzka, H., and Van de Weijer, J. (2011). Eye tracking: a comprehensive guide to methods and measures. OUP, Oxford.Search in Google Scholar

Johnston, K. and Everling, S. (2008). Neurophysiology and neuroanatomy of reflexive and voluntary saccades in non-human primates. Brain Cognit. 68: 271–283, in Google Scholar PubMed

Kaller, C.P., Heinze, K., Frenkel, A., Läppchen, C.H., Unterrainer, J.M., and Weiller, C. (2013). Differential impact of continuous theta-burst stimulation over left and right DLPFC on planning. Hum. Brain Mapp. 34: 36–51, in Google Scholar PubMed PubMed Central

Kan, R.L.D., Zhang, B.B.B., Zhang, J.J.Q., and Kranz, G.S. (2020). Non-invasive brain stimulation for posttraumatic stress disorder: a systematic review and meta-analysis. Transl. Psychiatry 10: 168, in Google Scholar PubMed PubMed Central

Kanai, R., Muggleton, N., and Walsh, V. (2012). Transcranial direct current stimulation of the frontal eye fields during pro- and antisaccade tasks. Front. Psychiatr. 3: 45, in Google Scholar PubMed PubMed Central

Klein, H.S., Vanneste, S., and Pinkham, A.E. (2021). The limited effect of neural stimulation on visual attention and social cognition in individuals with schizophrenia. Neuropsychologia 157: 107880, in Google Scholar PubMed

Lapenta, O.M., Sierve, K.D., de Macedo, E.C., Fregni, F., and Boggio, P.S. (2014). Transcranial direct current stimulation modulates ERP-indexed inhibitory control and reduces food consumption. Appetite 83: 42–48, in Google Scholar PubMed

Lim, J.Z., Mountstephens, J., and Teo, J. (2020). Emotion recognition using eye-tracking: taxonomy, review and current challenges. Sensors 20: 1–21.10.3390/s20082384Search in Google Scholar PubMed PubMed Central

Malyutina, S. and den Ouden, D. (2015). High-definition tDCS of noun and verb retrieval in naming and lexical decision. Neuroregulation 2: 111–125.10.15540/nr.2.3.111Search in Google Scholar

Meinzer, M., Yetim, Ö., McMahon, K., and de Zubicaray, G. (2016). Brain mechanisms of semantic interference in spoken word production: an anodal transcranial direct current stimulation (atDCS) study. Brain Lang. 157–158: 72–80, in Google Scholar PubMed

Meng, Z., Liu, C., Yu, C., and Ma, Y. (2014). Transcranial direct current stimulation of the frontal-parietal-temporal area attenuates smoking behavior. J. Psychiatr. Res. 54: 19–25, in Google Scholar PubMed

Mikkonen, M., Laakso, I., Tanaka, S., and Hirata, A. (2020). Cost of focality in TDCS: interindividual variability in electric fields. Brain Stimul. 13: 117–124, in Google Scholar PubMed

Nelson, J., Phillips, C., Mckinley, L., McIntire, R., Goodyear, C., and Monforton, L. (2019). The effects of transcranial direct current stimulation (tDCS) on multitasking performance and oculometrics. Mil. Psychol. 31: 1–15, in Google Scholar

Nelson, J., McKinley, R.A., Phillips, C., McIntire, L., Goodyear, C., Kreiner, A., and Monforton, L. (2016). The effects of transcranial direct current stimulation (tDCS) on multitasking throughput capacity. Front. Hum. Neurosci. 10: 589, in Google Scholar PubMed PubMed Central

Nitsche, M.A., Schauenburg, A., Lang, N., Liebetanz, D., Exner, C., Paulus, W., and Tergau, F. (2003). Facilitation of implicit motor learning by weak transcranial direct current stimulation of the primary motor cortex in the human. J. Cognit. Neurosci. 15: 619–626, in Google Scholar PubMed

Onoda, K., Okamoto, Y., Nakashima, K., Nittono, H., Yoshimura, S., Yamawaki, S., Yamaguchi, S., and Ura, M. (2010). Does low self-esteem enhance social pain? The relationship between trait self-esteem and anterior cingulate cortex activation induced by ostracism. Soc. Cognit. Affect Neurosci. 5: 385–391, in Google Scholar PubMed PubMed Central

Orquin, J.L. and Loose, S.M. (2013). Attention and choice: a review on eye movements in decision making. Acta Psychol. 144: 190–206, in Google Scholar PubMed

Paladini, R.E., Wyss, P., Kaufmann, B.C., Urwyler, P., Nef, T., Cazzoli, D., Nyffeler, T., and Müri, R.M. (2019). Re-fixation and perseveration patterns in neglect patients during free visual exploration. Eur. J. Neurosci. 49: 1244–1253, in Google Scholar PubMed

Pisoni, A., Papagno, C., and Cattaneo, Z. (2012). Neural correlates of the semantic interference effect: new evidence from transcranial direct current stimulation. Neuroscience 223: 56–67, in Google Scholar PubMed

Polanía, R., Nitsche, M.A., and Ruff, C.C. (2018). Studying and modifying brain function with non-invasive brain stimulation. Nat. Neurosci. 21: 174–187, in Google Scholar PubMed

Prillinger, K., Radev, S.T., de Lara, G.A., Klöbl, M., Lanzenberger, R., Plener, P.L., Poustka, L., and Konicar, L. (2021). Repeated sessions of transcranial direct current stimulation on adolescents with autism spectrum disorder: study protocol for a randomized, double-blind, and sham-controlled clinical trial. Front. Psychiatr. 12: 680525, in Google Scholar PubMed PubMed Central

Qiao, Y., Hu, Q., Xuan, R., Guo, Q., Ge, Y., Chen, H., Zhu, C., Ji, G., Yu, F., Wang, K., et al.. (2020). High-definition transcranial direct current stimulation facilitates emotional face processing in individuals with high autistic traits: a sham-controlled study. Neurosci. Lett. 738: 135396, in Google Scholar PubMed

Raveendran, R.N., Tsang, K., Tiwana, D., Chow, A., and Thompson, B. (2020). Anodal transcranial direct current stimulation reduces collinear lateral inhibition in normal peripheral vision. PLoS One 15: e0232276, in Google Scholar PubMed PubMed Central

Reed, T. and Kadosh, R.C. (2018). Transcranial electrical stimulation (tES) mechanisms and its effects on cortical excitability and connectivity. J. Inherit. Metab. Dis. 41: 1123–1130, in Google Scholar PubMed PubMed Central

Regenold, W.T., Deng, Z.D., and Lisanby, S.H. (2022). Noninvasive neuromodulation of the prefrontal cortex in mental health disorders. Neuropsychopharmacology 47: 361–372, in Google Scholar PubMed PubMed Central

Reilly, J., Zuckerman, B., Kelly, A., Flurie, M., and Rao, S. (2020). Neuromodulation of cursing in American English: a combined tDCS and pupillometry study. Brain Lang. 206: 104791, in Google Scholar PubMed

Reis, J. and Fritsch, B. (2011). Modulation of motor performance and motor learning by transcranial direct current stimulation. Curr. Opin. Neurol. 24: 590–596, in Google Scholar

Reteig, L.C., Knapen, T., Roelofs, F.J.F.W., Ridderinkhof, K.R., and Slagter, H.A. (2018). No evidence that frontal eye field tDCS affects latency or accuracy of prosaccades. Front. Neurosci. 12: 617, in Google Scholar PubMed PubMed Central

Roesmann, K., Dellert, T., Junghoefer, M., Kissler, J., Zwitserlood, P., Zwanzger, P., and Dobel, C. (2019). The causal role of prefrontal hemispheric asymmetry in valence processing of words – insights from a combined cTBS-MEG study. Neuroimage 191: 367–379, in Google Scholar PubMed

Ross, L.A., McCoy, D., Wolk, D.A., Coslett, H.B., and Olson, I.R. (2010). Improved proper name recall by electrical stimulation of the anterior temporal lobes. Neuropsychologia 48: 3671–3674, in Google Scholar PubMed

Sanchez, A., Vanderhasselt, M.A., Baeken, C., and Raedt, R.D. (2016). Effects of tDCS over the right DLPFC on attentional disengagement from positive and negative faces: an eye-tracking study. Cognit. Affect Behav. Neurosci. 16: 1027–1038, in Google Scholar PubMed

Sanchez-Lopez, A., Raedt, R.D., Puttevils, L., Koster, E.H.W., Baeken, C., and Vanderhasselt, M.A. (2021). Combined effects of tDCS over the left DLPFC and gaze-contingent training on attention mechanisms of emotion regulation in low-resilient individuals. Prog. Neuro-Psychopharmacol. Biol. Psychiatry 108: 110177, in Google Scholar PubMed

Sanchez-Lopez, A., Vanderhasselt, M.A., Allaert, J., Baeken, C., and Raedt, R.D. (2018). Neurocognitive mechanisms behind emotional attention: inverse effects of anodal tDCS over the left and right DLPFC on gaze disengagement from emotional faces. Cognit. Affect Behav. Neurosci. 18: 485–494, in Google Scholar PubMed

Saxe, R. and Wexler, A. (2005). Making sense of another mind: the role of the right temporo-parietal junction. Neuropsychologia 43: 1391–1399, in Google Scholar PubMed

Schütz, A.C., Braun, D.I., and Gegenfurtner, K.R. (2011). Eye movements and perception: a selective review. J Vis. 11: 1–30.10.1167/11.5.9Search in Google Scholar PubMed

Sifneos, P.E. (1973). The prevalence of ‘alexithymic’ characteristics in psychosomatic patients. Psychother. Psychosom. 22: 255–262, in Google Scholar PubMed

Singh, H. and Singh, J. (2012). Human eye tracking and related issues: a review. Int. J. Sci. Res. Pub. 2: 1–9.Search in Google Scholar

Zénon, A. (2019). Eye pupil signals information gain. Proc. Biol. Sci. 286: 20191593, in Google Scholar PubMed PubMed Central

Zhang, L., Xuan, R., Chen, Q., Zhao, Q., Shi, Z., Du, J., Zhu, C., Yu, F., Ji, G., and Wang, K. (2022). High-definition transcranial direct current stimulation modulates eye gaze on emotional faces in college students with alexithymia: an eye-tracking study. Prog. Neuro-Psychopharmacol. Biol. Psychiatry 116: 110521, in Google Scholar PubMed

Received: 2022-07-05
Accepted: 2022-09-07
Published Online: 2022-10-31
Published in Print: 2023-04-25

© 2022 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 26.2.2024 from
Scroll to top button