Insurers are starting to cover TMS for depression (after determining that SSRIs or other medications aren’t working for the patient). A full course, 24-36 treatments, of TMS can cost well over $10k. Though this is purely conjecture on my part, one way tDCS might make it into the mainstream is as a method to ‘top up’ post-TMS treatment as effects begin to fade.
Published on Jun 19, 2017 | YouTubeUCLA
As the number of people suffering from depression rises, doctors are looking for new, more targeted ways to treat it. One approach used by doctors at UCLA and a handful of other centers nationwide is to beam magnetic pulses deep into patients’ brains, a therapy known as transcranial magnetic stimulation (TMS). The therapy is time-consuming, and only a few hospitals or clinics offer it, but its ability to work in a fundamentally different way from medications is also what makes it so promising for people not helped by drugs.
Wow! No less than Hank Green ( of the Vlog Brothers) covering tDCS on his SciShow Psych! He sounds a little skeptical! So we have that in common. I pretty much agree with Hank’s perspective, just a couple of thoughts I’d like to share.
Most companies (but not all) know better than to make claims about tDCS. They know they have to be careful making claims of benefits. So where you see a company making a claim, they are most likely basing the claim on legit science. But are the benefits replicable in your situation? Hank refers to the (science) literature as ‘messy’ and he’s right, with different labs coming to opposite conclusions using basically the same experiment protocols.
Hank characterizes the basic function of tDCS as being a training session for neurons. Over time, with repeated stimulation, those neurons will start to fire more. While this is a legitimate description of the approach some research takes, I think a better way to think of it is that tDCS makes it easier for neurons that are already inclined to fire, to do so. As in- you’re focused on a “Where’s Waldo” task, and with the proper stimulation, the task is easier to do, because the targeted neurons have less resistance to firing.
Mike Weisend – Treating the Brain from the Outside We met Michael Weisend back in podcast #4 (March 2013!) and have been following along ever since. In this interview Mike discusses what he’s been up to at Rio Grande Neurosciences. What caught my ear especially were the discussion around ‘closed-loop TES’, where EEG information informs when and where to stimulate with TES. Also, his discussion of personalized disposable bio-degradeable electrodes was interesting. Mike closes the interview with an invitation to anyone knowing how to engineer an ‘EEG amplifier’ that would allow for the separation of EEG data and active TES stimulation, to contact him. (mike.weisend [theAtSign] riograndeneurosciences.com). Kudos to Richard Jacobs for an interesting interview.
In the third section of his talk (around 30 minute mark), Dr. McConnell discusses an experiment they are working on that uses EEG to monitor sleep, and according to their protocol, turn on a TES device (tACS-like) in order to induce slow wave EEG activity. The practical application is improved memory consolidation in Alzheimer’s patients. Very interesting!
Published on May 14, 2017 Neurology Grand Rounds 3 May 2017 – Transcranial Electrical Stimulation: A Stimulating Discussion of Current Research.
Brice McConnell, MD, PhD
University of Colorado
Finnish company Sooma manufactures and supports a tDCS device for the treatment of depression (in Europe). They recently added clearance to treat pain in Canada, and I would assume, are aggressively working towards clearing their device for the treatment of depression in Canada and the U.S.
I would recommend muting the sound (captioned so not necessary) in these next two.
If you follow the blog you’ll know I’m not savvy enough in the ways of electronics to know a well-constructed DIY circuit when I see it. I’ve generally depended on the Reddit crowd to sort through the pros and cons of DIY tDCS circuit design. Now that there are a handful of professionally developed and readily available devices on the market, I’m not seeing as many DIY projects, but here’s a couple that popped up on Youtube in the last week or so.
According to Instructables/reddit user quicksilv3rflash…
This device can be used for any kind of human electrical stimulation, such as tDCS, tACS, tRNS, or tVNS. Its hardware, when properly constructed and tested, limits output current such that -2.1mA < output_current < +2.1mA , based on the 2mA safety limit recommended in these published guidelines.
Lew Lim, the founder and CEO of VieLight is seen explaining the device in the video.
The technology is called transcranial and intranasal photobiomodulation (PBM). Initial, small-scale results, are promising.
Five people, with mild to moderate Alzheimer’s, used the headsets every day for 12 weeks. The headset frame, with four different LED cluster-heads and an LED that clips to the inside of the nostril, was turned on for 15 minutes a day.
After the three months, neuroscientists noticed some patients, who were not able to speak in full sentences, could now put sentences together. Patients also experienced improved sleep and reduced wandering.
Each day for two weeks, Bennett would don a headband equipped with moistened sponges and attached to what she called a “big cellphone”—a tDCS stimulator. When she was ready to start the session, a clinician would give her a four-digit code to enter on a keypad, and the current would surge through the wires and into her brain.