Safety, Tolerability, and Acute Effects of Transcranial Direct Current Stimulation on Vocal Performance in Adolescent Singers Aged 12 to 16 Years: A Randomized Sham-Controlled Proof-of-Concept Study
Sponsor study identifier
interventional
24
1 country
1
Study Start
October 7, 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
Primary Completion
December 30, 2026
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Study Completion
December 31, 2026
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
This randomized, sham-controlled proof-of-concept study aims to investigate the safety, tolerability, and acute effects of transcranial direct current stimulation (tDCS) on vocal performance in adolescent singers aged 12 to 16 years. Twenty-four participants will be randomly assigned in a 1:1 ratio to active or sham tDCS. Active stimulation will consist of 2.0 mA anodal tDCS applied for 20 minutes using 5 × 7 cm electrodes, with the anode positioned over C5 to target the left laryngeal primary motor cortex and the cathode over the right supraorbital region. Participants will perform the same standardized vocal piece before stimulation, immediately after stimulation, and approximately two hours after stimulation. Vocal performances will be audiovisually recorded and evaluated by blinded expert raters using an adapted analytical vocal-performance rubric based on Gynnild (2015). Safety and tolerability will be monitored using a structured symptom checklist and predefined stopping criteria. Self-rated vocal performance, nervousness, confidence, blinding, and protocol feasibility will also be explored.
Registry-reported information. Elapsed time and enrollment totals alone do not measure study progress or recruitment pace.
December 31, 2026
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
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Dates and qualifiers reported by the registry. Estimated dates do not confirm that a milestone has occurred.
September 30, 2026
Actual (reported)October 6, 2026
Actual (reported)October 7, 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
December 30, 2026
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
December 31, 2026
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Incidence and Severity of Treatment-Emergent Adverse Events Associated With Transcranial Direct Current Stimulation
Treatment-emergent adverse events will be assessed using a structured checklist documenting the presence and intensity of tingling/itching, warmth or burning sensation, skin redness, headache, dizziness, nausea, fatigue or drowsiness, visual symptoms, and other spontaneously reported symptoms. Symptoms present at baseline will be recorded, and an event will be considered treatment-emergent if it occurs after the start of stimulation or increases in intensity relative to baseline. For each event, severity will be categorized as none, mild, moderate, or severe. Stimulation interruptions, inability to complete the stimulation session, and adverse events requiring additional assessment or care will also be recorded. The number and proportion of participants experiencing each treatment-emergent adverse event, together with its severity, will be reported.
Baseline (pre-stimulation); during the 20-minute stimulation session; immediately post-stimulation; 2 hours post-stimulation; and approximately 24 hours post-stimulation.
Change in Vocal Performance Scores
Vocal performances will be audiovisually recorded and evaluated by blinded independent expert raters using an adapted analytical vocal-performance rubric based on Gynnild (2015). The rubric evaluates Technique, Language/Text, Musicality, Ability to Communicate, and Choice of Repertoire. Performance grades range from A to F and are converted to numerical values from 5 to 0, with higher scores indicating better vocal performance. Because all participants perform the same standardized repertoire, the Choice of Repertoire domain will not contribute to the primary performance score. The primary vocal-performance score will be calculated as the mean of the four applicable domain scores (Technique, Language/Text, Musicality, and Ability to Communicate), each scored from 0 to 5, resulting in an overall mean score ranging from 0 to 5. Higher scores indicate better vocal performance. Changes over time will be compared between the active and sham groups.
Participants will receive a single 20-minute session of active transcranial direct current stimulation (tDCS) at 2.0 mA using 5 × 7 cm electrodes, with the anode positioned over C5 to target the left laryngeal primary motor cortex and the cathode positioned over the right supraorbital region.
Participants will receive a single 20-minute sham tDCS session using the same electrode montage as the active condition. Sham stimulation will reproduce the initial sensations associated with tDCS through an initial ramp-up and brief stimulation period, without sustained current delivery.
Participants will receive a single session of active transcranial direct current stimulation (tDCS). The anode will be positioned over C5, targeting the left laryngeal primary motor cortex, and the cathode over the right supraorbital region using 5 × 7 cm electrodes. Current will be gradually increased to 2.0 mA, maintained for 20 minutes, and gradually reduced at the end of stimulation.
Orquestra Maré do Amanhã
Rio de Janeiro, Rio de Janeiro, 21042-432, Brazil
Gynnild V. Assessing vocal performances using analytical assessment: a case study. Music Education Research. 2015. doi:10.1080/14613808.2015.1025732.
Oliveira KSC, Gomes AOC, Brito R, Albuquerque RM, de Moura SRC, Monte-Silva K. Optimal Brain Targets for Enhancing Vocal Performance With Transcranial Direct Current Stimulation. J Voice. 2024 Dec 14:S0892-1997(24)00391-6. doi: 10.1016/j.jvoice.2024.11.011. Online ahead of print.
Antal A, Bjekic J, Ganho-Avila A, Alekseichuk I, Assecondi S, Bergmann TO, Bikson M, Brunelin J, Brunoni AR, Charvet L, Chen R, Cohen Kadosh R, Diedrich L, D'Urso G, Ferrucci R, Filipovic SR, Fitzgerald PB, Floel A, Frohlich F, George MS, Hamilton RH, Haueisen J, Hallett M, Herrmann CS, Hummel FC, Jaberzadeh S, Langguth B, Lavidor M, Lefaucheur JP, Miniussi C, Moliadze V, Nikander M, Nikolin S, Nitsche MA, Opitz A, O'Shea J, Padberg F, Plewnia C, Priori A, Ramasawmy P, Razza LB, Rossi S, Rothwell J, Rueger MA, Ruffini G, Sack AT, Salvador R, Schellhorn K, Schuhmann T, Shirota Y, Siebner HR, Thielscher A, Ugawa Y, Uusitalo S, Wexler A, Paulus W, Vanderhasselt MA, Van Waes V, Wessel MJ, Wischnewski M, Baeken C, Ziemann U. Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines (2017-2025: An update) - endorsed by the European Society for Brain Stimulation (ESBS) and by the International Federation for Clinical Neurophysiology (IFCN). Clin Neurophysiol. 2026 Apr;184:2111436. doi: 10.1016/j.clinph.2025.2111436. Epub 2025 Nov 23.
First Submitted
September 30, 2026
First Posted
October 6, 2026
Study Start
October 7, 2026
Effects of tDCS in Elderly With Pain Due to Knee Osteoarthritis
Baseline, immediately after intervention, and 2 hours after intervention
Change in Vocal Performance Scores
Vocal performances will be audiovisually recorded and evaluated by blinded independent expert raters using an adapted analytical vocal-performance rubric based on Gynnild (2015). The rubric evaluates technique, language/text, musicality, ability to communicate, and choice of repertoire. Performance grades range from A to F and are converted to numerical values from 5 to 0, with higher scores indicating better vocal performance. Because all participants perform the same standardized repertoire, the choice-of-repertoire domain will not contribute to the primary performance score. The primary vocal-performance score will be calculated from the applicable rubric domains, and changes over time will be compared between the active and sham groups.
Baseline, immediately after intervention, and 2 hours after intervention
Change in Self-Reported Vocal Performance
Baseline, immediately after intervention, and 2 hours after intervention
Change in Self-Reported Nervousness
Baseline, immediately after intervention, and 2 hours after intervention
Change in Self-Reported Confidence
Baseline, immediately after intervention, and 2 hours after intervention
Participant Perception of Intervention Allocation
At the end of the study session, approximately 2 hours after intervention
Completion Rate
From enrollment through completion of the 2-hour post-intervention assessment
Participants will receive a single sham transcranial direct current stimulation (tDCS) session using the same electrode montage as the active condition, with the anode positioned over C5 and the cathode over the right supraorbital region using 5 × 7 cm electrodes. An initial ramp-up and brief stimulation period will reproduce the initial sensations associated with tDCS, followed by discontinuation of sustained current. The sham session will have the same overall duration as the active session.
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Moliadze V, Schmanke T, Andreas S, Lyzhko E, Freitag CM, Siniatchkin M. Stimulation intensities of transcranial direct current stimulation have to be adjusted in children and adolescents. Clin Neurophysiol. 2015 Jul;126(7):1392-9. doi: 10.1016/j.clinph.2014.10.142. Epub 2014 Oct 28.
Buchanan DM, Bogdanowicz T, Khanna N, Lockman-Dufour G, Robaey P, D'Angiulli A. Systematic Review on the Safety and Tolerability of Transcranial Direct Current Stimulation in Children and Adolescents. Brain Sci. 2021 Feb 10;11(2):212. doi: 10.3390/brainsci11020212.
This estimate has passed. The registry has not confirmed an actual date for this milestone.
Primary Completion
December 30, 2026
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Study Completion
December 31, 2026
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Last Updated
October 13, 2026
Record last verified: 2026-10
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