Zapping the brain to enhance sport performance? An umbrella review of the effect of transcranial direct current stimulation on physical performance

Concepts such as "neurodoping" have contributed to an expansion in the area of transcranial direct current stimulation (tDCS) and its impact over physical performance in recent years. This umbrella review examines meta-analyses to evaluate tDCS's impact on exercise performance in healthy individuals. We identified 9 meta-analyses that met our inclusion criteria, encompassing 50 crossover studies and 683 participants. Like previous meta-analyses, we found a small but significant effect across individual studies (g_z = 0.28, 95%CI [0.18, 0.39]). However, we also found clear evidence of publication bias, low power and substantial variability in methodological decisions. The average effect became non-significant after accounting for publication bias (g_rm = 0.10, 95%CrI [-0.04, 0.20], BF₁₀ = 0.99), and a specification curve analysis showed that the final effect could range from g = -0.23 to g = 0.33, depending on decisions such as the formula used for estimating the effect size and multiple additional analytic steps. Overall, our findings suggest that current evidence does not conclusively support acute tDCS as an exercise performance enhancer.