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. 2025 Mar 3:19:1501209.
doi: 10.3389/fnhum.2025.1501209. eCollection 2025.

Transcutaneous and transcranial electrical stimulation for enhancing military performance: an update and systematic review

Onno van der Groen  1 , Sara A Rafique  2 , Nick Willmot  1 , Margaret G Murphy  3   4 , Eulalia Tisnovsky  4 , Tad T Brunyé  3   4
Affiliations

Transcutaneous and transcranial electrical stimulation for enhancing military performance: an update and systematic review

Onno van der Groen et al. Front Hum Neurosci. .

Abstract

Introduction: Electrical stimulation (ES), including transcranial electrical stimulation (tES) and transcutaneous vagus nerve stimulation (tVNS), has shown potential for cognitive enhancement in military contexts. Various types of ES, such as transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS), modulate neuronal membrane potentials and cortical excitability, potentially improving cognitive functions relevant to military training and operations.

Methods: This systematic review updates previous findings by examining studies published between 2019 and 2024 that investigated electrical stimulation effects on cognitive performance in military personnel and tasks. We focused on whether the studies addressed key questions about the generalizability of lab findings to military tasks, the frequency and intensity of adverse effects, the impact of repeated ES administration, and the ethical and regulatory considerations for its use in potentially vulnerable military populations.

Results: Eleven studies met the inclusion criteria; most demonstrated overall low to some concerns, however, two of these had overall high risk of bias. While tES and tVNS showed some promise for enhancing multitasking and visual search performance, the results were mixed, with no reliable effects on vigilance tasks.

Discussion: The reviewed studies highlight the need for a better understanding of ES mechanisms, optimal stimulation parameters, and individual differences in response to ES. They also highlight the importance of conducting high-powered research in military settings to evaluate the efficacy, safety, and ethical implications of ES. Future research should address the generalizability of lab-based results to real-world military tasks, monitor the frequency and intensity of adverse effects, and explore the long-term impacts of repeated administration. Furthermore, ethical and regulatory considerations are crucial for the responsible application of ES in military contexts, and a series of outstanding questions is posed to guide continuing research in this domain.

Keywords: human performance; military; peripheral nerve stimulation; transcranial alternating current stimulation; transcranial direct current stimulation; transcranial electrical stimulation; vagus nerve stimulation.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
PRISMA flow diagram depicting the flow of information through the three phases of our systematic review (identification, screening, inclusion).
See this image and copyright information in PMC

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