Dr. Jim Fugedy of the Brain Stimulation Clinic in Atlanta – DIY tDCS Podcast #2

[Apologies for audio quality. It won’t happen again.]

Dr. Jim Fugedy runs the Brain Stimulation Clinic, in Atlanta, GA, and has been treating patients using tDCS since 2007. Download the interview here (zipped mp3).

Dr. Jim Fugedy

Dr. Jim Fugedy

The Brain Stimulation Clinic in Atlanta is the destination for memory and learning enhancement and treatment-resistant patients who suffer from chronic pain, fibromyalgia, migraine headaches, CRPS, depression and tinnitus. Transcranial direct current stimulation (tDCS) therapy is provided in a pleasant, relaxing environment. Instruction, training and supervision for home use is also available for select patients.

Show Notes:
Jim is an anesthesiologist.
The study Jim refers to regarding Felipe Fregni & fibromyalgia:
A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia (full pdf)
tDCS for treatment of fibromyalgia is not certified – it’s ‘off label’
Device is certified, but not for tDCS = no insurance code, can’t be billed to insurance
20 minute treatment for 5 days.
For fibromyalgia – reduces pain, improves issues – fatigue, compromised mental function
2″ electrodes
(ActivaDose ii Update 3/16 now available as complete tDCS kit through Caputron Medical, use voucher code ‘diytdcs’ for generous discount.)
Most benefit… chronic depression, treatment protocol based on Colleen Loo, Black Dog Institute 6 weeks, follow up maintenance. Up to 8 weeks of treatment + 1-2 treatments follow up maintenance.  Daily 20 minute sessions
Can be treated at the clinic for 1-2 weeks. Or home treatment package.
“To treat depression, I place the anode over the left dlpfc (left dorsolateral prefrontal cortex) and the cathode over the contralateral supraorbital area. I have tried positioning the cathode over the contralateral dlpfc and extracephalically (opposite shoulder or upper arm), but the contralateral supraorbital locations provides the most robust effect.” (Correspondence)
Pain montage 2mA, anode M1 & cathode contralateral supra-orbital area


anode at the right primary motor cortex (M1)–cathode on the left supra-orbital From: http://www.sciencedirect.com/science/article/pii/S1053811907000055

For chronic pain, the M1 is the most used area and that’s almost always my first choice.  But you can use the cathode over the somatosensory (S1) cortex, to down-regulate the patient’s perception of pain.
And you can also stimulate the Dorsalateral prefrontal cortex which is involved in the emotional component of pain.
Looking at stimulating right dorsalateral prefrontal cortex to attenuate anxiety.
… it may be a location
for the non-pharmaceutical treatment for ADD.
Office visit $150.
Home use treatment package $2400 includes in-office evaluation and training, ActivaDose ii device, electrodes, and unlimited follow-up via visit,  phone, skype…
Only side effect Jim has seen is skin burn (but easily avoided with sponge electrodes).
(Patient with skin burns who’d been treated by a doctor using electroencephalogram (EEG) electrodes.)
Tinnitus responds well, though temporarily, to tDCS
Anode, right dorsalateral prefrontal cortex, cortex opposite supra-orbital
Harvard one day course on how to treat with tDCS. Taught 3-4 times a year.
Contrast with approved Electromagnetic treatment for depression (I think he’s referring to TMS transcranial magnetic stimulation here) A 6 week 30 treatment protocol costs between $10-15,000. Affects last about 6 months. And even though it’s certified, it’s not covered by insurance.
…”in the 12 years that it’s been used there have been no side effects reported other than skin (irritations).
“You know we hear stories about Canadians having to wait for surgery. But in the United States, if you don’t have the money and you don’t have insurance,  you don’t have to worry about waiting, you won’t get the surgery.”

You can reach Jim at: doctorfugedy [theAtSignHere] transcranialbrainstimulation.com
Thanks Jim!

The Open tDCS Project

Update 7/2/14 First of all, thanks Z for pointing out the two schematics that are now considered dangerous, in the sense that they could lead to an initial ‘zap’ and possible burn.

As I’ve mentioned earlier, I myself am not an electronics person. The notion of ‘Open tDCS’ was to develop an excellent device through Upverter (or similar online platform), that anyone could then order directly from a Chinese manufacturer (thereby circumnavigating any regulation issues etc).
We have yet to find an engineer to lead and build the design team and my thoughts about why are simply that people are too busy, or that they see a possible financial gain for their own device somewhere down the road. Considering the original post/Upverter account is a year and a half old, it seems unlikely we’ll find someone, but you never know!
Upverter is an online platform that allows for electronics to be designed, parted, and built. As I understand it, once the design is fixed, you shop for parts – inside of Upverter, and then submit your project (to Upverter’s Chinese partners) to be built. I’d mentioned Upverter on the tDCS subReddit a few times. I was hoping to pique the curiosity of the engineer types that had designed and built their own tDCS devices… Crowdsource the design, and then anyone can order one!

What happened was I got an email from Eric Evenchick, a ‘customer success / hardware engineer person’ at Upverter! Eric had seen my post and written to help. He waived the team fee, set up the project and ported the OpenStim Arduino-based tDCS design, by ohsnapitsnathan (Reddit handle).

I hope I didn’t step on any toes by collecting these schematics to one place. I wanted engineers to be able to see quickly how other designers have thought about building their devices. If you’re an engineer type interested in tDCS please join our Upverter team.

It feels silly to put it this way, when the very nature of Open implies extreme democracy, but here goes… Here’s my vision of an Open tDCS project.

  • Build an Upverter team
  • Design, part, and prototype a minimum viable tDCS device
  • Working with an online ‘cognitive test’ site, build a protocol for measuring the effectiveness of tDCS

Later on we could develop a multi-channel device, and maybe this is just a fantasy, but if it could interact with the internet, researchers could design tests and collect data non-locally. How cool would that be?

The rest of this post will attempt to collect in one place the various schematics I’ve seen for DIY tDCS devices.

I called this one Imgur earlier on the blog. It comes from 55tfg7879fe42e345 (Reddit handle)

tDCS by 55tfg7879fe42e345

tDCS by 55tfg7879fe42e345


brmlab our Czech friends


The Focus device.

Focus V 1

Focus V 1

And then the more advanced, programmable tDCS devices. OpenStim



Open Stim Multi-Channel

OpenStim Multi-Channel

OpenStim Multi-Channel

Shawn Nock Version 2

Shawn Nock Version 2

Shawn Nock Version 2

If you know of a schematic I missed please let me know, and even if you’re not an engineer, consider joining Upverter and ‘Following’ our project.




Ana Maiques of Neuroelectrics – DIY tDCS Podcast # 1

Well here we go! Episode one of the DIY tDCS podcast. Ana Maiques is co-founder (with Giulio Ruffini) of Spanish-based Starlab. Their spin-off company, Neuroelectrics makes Enobio, a research-quality wireless EEG device, and Starstim, a multi-channel wireless tcs & tDCS device. Download the interview here (zipped mp3). Show notes after the fold.

Ana Maiques of Starlab and Enobio

Ana Maiques of Starlab and Enobio

Ana Maiques wearing her Enobio

Ana Maiques wearing her Enobio

(If you speak Spanish you might enjoy the interview these photos were taken from.) Also, if you’re an EEG or tDCS researcher or clinician (or VC) on the East Coast, Ana is frequently in the New York and Boston area and is happy to discuss Enobio and Starstim. Neuroelectrics will be at the Advances in Mediation Research conference in NY Jan. 17 2013. (Schedule)  Check out the Neuroelectrics blog for excellent tDCS and EEG info.

Show Notes
Starlab is the parent company > Space (sensors) + Neuroscience
Cutting edge research > impact on society… products and services
Twelve years of research in neuroscience > Enobio, Starstim
Initial market is early adopters – researchers, clinicians and practitioners
Starstim (tDCS) > chronic pain, stroke rehabilitation (later… depression >> cognitive enhancement, addiction)
Medically certified in Europe and Canada
Filing 510k for Enobio in the US
Starstim has 8 channels for use as HD tDCS but can also use traditionally
Can also do tACS (alternating current), or random noise stimulation and at the same time Simultaneously record EEG
Can also use dry EEG electrodes
Roi Cohen Kadosh Oxford study, kids etc. (Link to video we discussed. NewScientist)
Study will determine if tDCS is efficacious in enhancing performance in certain areas (math)
Will have implications for people with Alzheimers
Partnerships with 15 hospitals doing research with Starstim
8 in U.S. and 7 in Europe. Different pathologies. Results to be published soon.
Post-stroke rehabilitation is a great place to see the effectiveness of tDCS
tDCS > Motor recovery… hand rehabilitation…
Can thereby measure the degrees of movement and improvement very objectively
Couple of groups showing very measurable results.
The Muse, Neurosky, Emotiv Home EEG devices?
Limitation is number of channels.
Started Enobio with 4 channels, but feedback from medical community lead to  developing a 20 channel Enobio.
For certain applications – games, BCI etc, the home EEG devices might be fine
But we’re looking at the medical application of EEG.
Doctors and researchers require the maximum coverage of the head.
Signal quality is very important.
EEG application
Emotion recognition, neural marketing, traumatic brain injury – concussion
BCI – wheelchairs.
Sponsoring a conference in NY on meditation. Sloan Kettering pre-chemo
medications >> less pain, better toleration of treatment.
Spanish VCs even more conservative since crisis
Patents >> cloud-based database recording experimental data
Software runs on a Mac.
We always said we want to be the Apple of neuroscience…”

Neuroelectrics Starstim

Starstim tDCS

Neuroelectrics Enobio

Enobio EEG

NIBS Non-Invasive Brain Stimulation – The Air Force Research Laboratory and tDCS

NIBS Non-Invasive Brain Stimulation

Every military application of tDCS I’ve seen so far specifically mentions drones and drone pilot training. This logo has a drone in it! For the record, I think the use of drones is illegal and immoral, and that the deaths of innocents is un-American and unacceptable. That said, the tDCS research coming out of this sector is fascinating and will no doubt have an impact beyond military training.

[Update 7/30/14 I’ve replaced the old (broken) link with an active one that comes via Ryan (see comment below)] http://colonyofcommodus.files.wordpress.com/2013/02/2012-afosr-review-mckinley.pdf it was a public document. It appears to be a set of slides used in a presentation. It documents the most aggressive use of tDCS for the purpose of learning and cognitive enhancement I’ve seen. You will conclude, after reading this, that the Air Force is not fooling around.

Air Force Research Laboratory Skill Learning tDCS

Here is one of the more shocking aspects of the research: The notion that cathodal stimulation can have a positive effect by depressing ‘competing memory’. What? The plot thickens.

Air Force Research Laboratory Skill Learning tDCS

There is weeks of research ahead for anyone diving deeply into this paper. A lot of new questions to answer.

tDCS Recent Activity 12/12 – 1/13

A lot of the ‘pop sci’ articles are drawing on the results of only a few studies. Hopefully we’ll get affirmation of the efficacy of tDCS in cognitive enhancement soon.

Does Passing A Small Current Through Your Brain Really Make You Smarter?

Excellent update from Giulio Ruffini of Neuroelectrics. Full of links to relevant papers.

tDCS and Stroke: What We Know So Far (Jan 2013)

As far as I can tell, this is a new development in understanding the mechanism for the mediation of pain using tDCS.

Immediate effects of tDCS on the μ-opioid system of a chronic pain patient
To our knowledge, we provide data for the first time in vivo that there is possibly an instant increase of endogenous μ-opioid release during acute motor cortex neuromodulation with tDCS.
(And the pop-sci media follow-up Electrical Current Can Unlock The Seriously Good Drugs In Your Brain and Happiness Is a Warm Transcranial Direct Current Electrode)

A lot of research is going on right now into understanding where exactly, current if flowing.

The electric field in the cortex during transcranial current stimulation
The aim of this study was to investigate the effect of tissue heterogeneity and of the complex cortical geometry on the electric field distribution.

Some context.

A pioneer work on electric brain stimulation in psychotic patients. Rudolph Gottfried Arndt and his 1870s studies.
Today’s brain stimulation methods are commonly traced back historically to surgical brain operations. With this one-sided historical approach it is easy to overlook the fact that non-surgical electrical brain-stimulating applications preceded present-day therapies.

Mental Practice, or MP is practicing doing something without actually doing it. A musician imagining playing their instrument for instance. This study measured quality of handwriting with the non-dominant hand while using tDCS.

Site-specific effects of mental practice combined with transcranial direct current stimulation on motor learning
In conclusion, our results suggest that MP-induced effects in improving motor performance can be successfully consolidated by excitatory non-invasive brain stimulation on the M1 and left DLPFC.

Marom Bikson’s ‘tDCS State of the Art’ Lecture Now On YouTube

There’s just so much going on in tDCS right now that it’s hard to keep track. Coupled with the fact that I don’t have a Uni account that lets me access new paper (although I’ve had some help there from time to time). One of my objectives is to understand what’s going on well enough to present you with an accurate overview of what’s new. But lately research papers are coming so quickly that it’s been overwhelming.

But here’s my take-away from Marom’s lecture: Electrode placement does not necessarily correlate with current flow! At least not the way one might assume. Watch the videos to get a clear picture.