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

A-M1-C-contralateral-supraorbital

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!

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