Acute effects of anodal transcranial direct current stimulation on whole-body dynamic endurance performance: a systematic review and meta-analysis

OBJECTIVE: Anodal transcranial direct current stimulation (tDCS) has been suggested to enhance endurance performance, yet the influence of stimulation parameters and participant characteristics remains unclear. This study aimed to conduct a comprehensive meta-analysis to quantify the acute effects of anodal tDCS on endurance performance, examine potential moderators, and explore dose-response relationships. METHODS: A systematic search was conducted (August 21, 2025) in Web of Science, PubMed, and SPORTDiscus. A three-level random-effects meta-analysis was performed, and standardized mean differences (SMD) were calculated. Subgroup and meta-regression analyses were used to examine moderating factors. RESULTS: Twenty-four randomized crossover trials (n = 347) were included. Anodal tDCS significantly improved time to exhaustion (TTE) compared with sham stimulation (SMD = 0.58, 95% CI: 0.23, 0.94; p = 0.001). A small, non-significant effect was observed for time-trial (TT) performance (SMD = 0.42, 95% CI: -0.00, 0.85; p = 0.051). Subgroup analysis showed that stimulation over the primary motor cortex (M1) yielded greater improvements in TTE, and recreationally active individuals responded more strongly. Meta-regression revealed a U-shaped relationship between stimulation duration and TTE effect. CONCLUSION: Anodal tDCS significantly prolonged TTE but did not reliably improve TT performance. The ergogenic effect appears to depend on electrode montage, training status, testing protocol, and stimulation duration. These findings provide updated evidence to guide the use of tDCS as a potential ergogenic aid in endurance sports.