tDSC Papers of Note April 2013

Regional personalized electrodes to select transcranial current stimulation target (pdf)
…with the present work we developed a procedure to properly shape the stimulating

(The familiar looking square electrodes were the reference electrodes.)
Tags: electrodes, tACS

The Sertraline vs Electrical Current Therapy for Treating Depression Clinical StudyResults From a Factorial, Randomized, Controlled Trial (pdf)
At the main end point, there was a significant difference in Montgomery-Asberg Depression Rating Scale scores when comparing the combined treatment group (sertraline/active tDCS) vs sertraline only, tDCS only, and placebo/sham tDCS… There were 7 episodes of treatment-emergent mania or hypomania, 5 occurring in the combined treatment group.
Tags: depression

Noninvasive transcranial direct current stimulation over the left prefrontal cortex facilitates cognitive flexibility in tool use (pdf)
The results support the hypothesis that certain tasks may benefit from a state of diminished cognitive control.
And a related news story discussing the same paper.
Brain hacking: Electrifying your creative side
Each person was shown pictures of everyday objects and asked to come up with a new uses for them.
The group which received the TDCS muting the left prefrontal cortex was better in coming up with unusual uses than the others — and did it faster.
Tags: creativity, Sharon Thompson-Schill, cathodal stimulation,

 Orchestrating neuronal networks: sustained after-effects of transcranial alternating current stimulation depend upon brain states (pdf)
Long lasting after-effects foster the role of tACS as a tool for non-invasive brain stimulation and demonstrate the potential for therapeutic application to reestablish the balance of altered brain oscillations.
Tags: tACS

Different Current Intensities of Anodal Transcranial Direct Current Stimulation Do Not Differentially Modulate Motor Cortex Plasticity (pdf)
targeting M1 …10 minutes of anodal tDCS at 0.8, 1.0, and 1.2 mA
These results suggest that the aftereffect of anodal tDCS on facilitating cortical excitability is due to the modulation of synaptic mechanisms associated with long-term potentiation and is not influenced by different tDCS intensities.
Tags: M1, dosage

Transcranial direct-current stimulation increases extracellular dopamine levels in the rat striatum (pdf)
Following the application of cathodal, but not anodal, tDCS for 10 min, extracellular dopamine levels increased for more than 400 min in the striatum. There were no significant changes in extracellular serotonin levels.
Tags: dopamine

Spark of Genius: A new technology promises to supercharge your brain with electricity. Is it too good to be true?
Surprisingly good pop-sci overview of where we’re at with tDCS. Chock full of relevant links.

Using computational models in tDCS research and clinical trials (pdf)
Hypothesis: Appropriately applied computational models are pivotal for rational tDCS dose selection.
Tags: Comptational modeling, Marom Bikson,

Boosting brain functions: Improving executive functions with behavioral training, neurostimulation, and neurofeedback  (pdf)
This review provides a synopsis of two lines of research, investigating the enhancement of capabilities in executive functioning: a) computerized behavioral trainings, and b) approaches for direct neuromodulation (neurofeedback and transcranial electrostimulation).
Tags: cognitive enhancement

Focal Modulation of the Primary Motor Cortex in Fibromyalgia Using 4×1-Ring High-Definition Transcranial Direct Current Stimulation (HD-tDCS): Immediate and Delayed Analgesic Effects of Cathodal and Anodal Stimulation (pdf)
We found that both active stimulation conditions led to significant reduction in overall perceived pain as compared to sham.
Tags: Fibromyalgia, HD-tDCS, Marom Bikson, pain

Articles of Note – March 2013

(What happened to February?)
Transcranial Direct Current Stimulation (tDCS) of the visual cortex: a proof-of-concept study based on interictal electrophysiological abnormalities in migraine (pdf)
with anodal tDCS turned out to be beneficial in MoA (migraine without aura patients) migraine attack frequency, migraine days, attack duration and acute medication intake significantly decreased during the treatment period compared to pre-treatment baseline
Tags: Migraine, visual cortex,

The Mental Cost of Cognitive Enhancement (pdf)
Stimulation to the the posterior parietal cortex facilitated numerical learning, whereas automaticity for the learned material was impaired. In contrast, stimulation to the dorsolateral prefrontal cortex impaired the learning process, whereas automaticity for the learned material was enhanced.
Wired Version
New Scientist Version
Tags: Roi Cohen Kadosh,

Keith Spalding’s Simple DIY TDCS circuit using CRDs
A DIY schematic for tDCS using CRDs for current regulation.
Tags: DIY, CRD

Noninvasive transcranial direct current stimulation over the left prefrontal cortex facilitates cognitive flexibility in tool use
…we hypothesized that cathodal (inhibitory) transcranial direct current stimulation (tDCS) will facilitate performance in a flexible use generation task.
The results support the hypothesis that certain tasks may benefit from a state of diminished cognitive control.
Tags: inhibitory benefits,

When Anger Leads to Rumination
Induction of Relative Right Frontal Cortical Activity With Transcranial Direct Current Stimulation Increases Anger-Related Rumination
…results suggest that anger associated with greater relative left frontal cortical activity predicts approach-oriented aggressive action, whereas anger associated with greater relative right frontal cortical activity predicts inhibited rumination.

Potential of transcranial direct current stimulation shown in fibromyalgia
Transcranial direct current stimulation delivered focally to the left primary motor cortex of patients with fibromyalgia significantly reduced perceived pain compared with sham stimulation in a proof-of-principle pilot trial.
Tags, fibromyalgia, pain

February 2013 tDCS Papers of Interest

If there’s no link to a pdf, it means the full paper is behind a paywall. If you find a public link to the full paper, please send it along and I’ll update the post. Did I miss anything 😉
Bold: Paper title, linked to Abstract
(pdf): Direct pdf download where available
Italic: ‘Takeaway’ snippet from abstract.
(Bracketed): My thoughts FWIW

Transcranial direct current stimulation increases resting state interhemispheric connectivity.
the tDCS group showed increased DLPFC connectivity to the right hemisphere and decreased DLPFC connectivity to the brain regions around the stimulation site in the left hemisphere. (Lends more credence to the idea of increasing positive effects of tDCS by simultaneously damping down (cathodal) and ramping up (anodal) neuronal activity.)
Tags: theory, learning, enhancement

Transcranial direct current stimulation for treatment of refractory childhood focal epilepsy.
A single session of cathodal tDCS improves epileptic EEG abnormalities for 48 h and is well-tolerated in children.
Tags: epilepsy, children

Brain stimulation modulates the autonomic nervous system, rating of perceived exertion and performance during maximal exercise.
…indicating that the brain plays a crucial role in the exercise performance regulation.
Tags: sports medicine

Evolution of Premotor Cortical Excitability after Cathodal Inhibition of the Primary Motor Cortex: A Sham-Controlled Serial Navigated TMS Study (pdf)
Cathodal inhibition of M1 excitability leads to a compensatory increase of ipsilateral PMC (premotor cortical regions) excitability. (Cathodal tDCS used as a tool to facilitate an experiment)
Tags: theory,

Rethinking Clinical Trials of Transcranial Direct Current Stimulation: Participant and Assessor Blinding Is Inadequate at Intensities of 2mA (pdf) (See also: A big hole in the control? Transcranial direct current stimulation blinding on trial)
Our results suggest that blinding in studies using tDCS at intensities of 2 mA is inadequate. Positive results from such studies should be interpreted with caution.
Tags: theory, sham, blinding,

The effects of cross-hemispheric dorsolateral prefrontal cortex transcranial direct current stimulation (tDCS) on task switching
Task switching, defined as the ability to flexibly switch between tasks in the face of goal shifting, is a central mechanism in cognitive control. …Our findings confirm the notion that involvement of the PFC on task switching depends critically on laterality, implying the existence of different roles for the left hemisphere and the right hemisphere in task switching.
Tags: task switching, theory

The role of timing in the induction of neuromodulation in perceptual learning by transcranial electric stimulation
tRNS (transcranial random noise stimulation) facilitated task performance only when it was applied during task execution, whereas anodal tDCS induced a larger facilitation if it was applied before task execution. (This study showed tDCS to be more effective when applied prior to training! (i.e. ‘offline’)
Tags: tRNS, offliine, online, training, enhancement, perceptual learning

Modulation of verbal fluency networks by transcranial direct current stimulation (tDCS) in Parkinson’s disease
…left dorsolateral prefrontal cortex (DLPFC) tDCS increased performance on the phonemic fluency task
Tags: Parkinson’s, verbal fluency

Transcranial Electrical Currents to Probe EEG Brain Rhythms and Memory Consolidation during Sleep in Humans (2011) (pdf)
…results demonstrate the suitability of oscillating-tDCS as a tool to analyze functions of endogenous EEG rhythms and underlying endogenous electric fields as well as the interactions between EEG rhythms of different frequencies. (Way over my head at this point but trying to understand it, as Lisa Marshall is frequently mentioned in discussions around tDCS and memory. I’m also trying to build an understanding of EEG.)
Tags: memory consolidation, EEG, theory

(pdf) Random Noise Stimulation Improves Neuroplasticity in Perceptual Learning (2011)
Our results confirmed the efficacy of hf-tRNS over the visual cortex in improving behavioral performance and showed its superiority in comparison to other TES. (tRNS transcranial random noise stimulation, has been showing up more often in relation to studies focused on learning and cognition.)
Tags: tRNS, perceptual learning, neural plasticity,

Focal Modulation of the Primary Motor Cortex in Fibromyalgia Using 4×1-Ring High-Definition Transcranial Direct Current Stimulation (HD-tDCS): Immediate and Delayed Analgesic Effects of Cathodal and Anodal Stimulation
4×1-ring HD-tDCS, a novel noninvasive brain stimulation technique capable of more focal and targeted stimulation, provides significant reduction in overall perceived pain in fibromyalgia patients..
Tags: HD-tDCS, Fibromyalgia, pain health

Transcranial direct current stimulation’s effect on novice versus experienced learning (2011)
TDCS was significantly more effective in enhancing test performance when applied in novice learners than in experienced learners.
Tags: learning, threat detection, anode F8,

Evaluation of sham transcranial direct current stimulation for randomized, placebo-controlled clinical trials.
The tDCS sham condition investigated here may be suitable for placebo-controlled trials keeping subjects blind to treatment conditions. (The protocol for sham tDCS is necessarily evolving.)
Tags: sham,

Tremor Suppression by Rhythmic Transcranial Current Stimulation
With this technique we can achieve almost 50% average reduction in resting tremor amplitude and in so doing form the basis of a closed-loop tremor-suppression therapy that could be extended to other oscillopathies. (tACS transcranial alternating current)
Tags: Parkinsons, tremor, tACS

Is Transcranial Alternating Current Stimulation Effective in Modulating Brain Oscillations? (pdf)
Therefore, the present study does not provide significant evidence for tACS reliably inducing direct modulations of brain oscillations that can influence performance in a visual task.
Tags: tACS, posterior parietal cortex, visual perception

Neuromodulation for Brain Disorders: Challenges and Opportunities (pdf)
This article reviews the state-of-the-art of neuromodulation for brain disorders and discusses the challenges and opportunities available for clinicians and researchers interested in advancing neuromodulation therapies. (Excellent overview of where we’re at with various forms of brain stimulation)
Tags: Neuromodulation, brain stimulation, tDCS, DBS (Deep Brain Stimulation), ICS (intracranial cortical stimulation), TMS (transcranial magnetic stimulation)

Improved proper name recall in aging after electrical stimulation of the anterior temporal lobes (2011) (pdf)
The task was to look at pictures of famous faces or landmarks and verbally recall the associated proper name. Our results show a numerical improvement in face naming after left or right ATL stimulation, but a statistically significant effect only after left-lateralized stimulation.
Tags: name recall, anterior temporal lobes, aging,

Transcranial brain stimulation (not sure this link will work for you pdf)
This book reviews recent advances made in the field of brain stimulation techniques. Moreover NIBS techniques exert their effects on neuronal state through different mechanisms at cellular and functional level.
Tags: NIBS (non-invasive brains stimulation), research overview,

Naming facilitation induced by transcranial direct current stimulation. (2010)
…anodal tDCS of the left DLPFC improves naming performance, speeding up verbal reaction times after the end of the stimulation, whereas cathodal stimulation had no effect.
Tags: learning, left DLPFC,

Consolidation of Human Motor Cortical Neuroplasticity by D-Cycloserine (2004) (pdf)
While anodal tDCS enhances motor cortical excitability, cathodal tDCS diminishes it. Both effects seem to be NMDA receptor dependent. D-CYC selectively potentiated the duration of motor cortical excitability enhancements induced by anodal tDCS.(Again, way over my head, but NMDA receptors comes up frequently in the context of tDCS and neurotransmitters.)
Tags: NMDA receptors, D-Cycloserine, learning, enhancement

Interactions between transcranial direct current stimulation (tDCS) and pharmacological interventions in the Major Depressive Episode: Findings from a naturalistic study. (See also: Electrical Brain Stimulation Plus Drug Fights Depression)
…To investigate the interactions between tDCS and drug therapy …tDCS over the DLPFC acutely improved depressive symptoms.
Tags: depression, Zoloft

Physiological and modeling evidence for focal transcranial electrical brain stimulation in humans: A basis for high-definition tDCS.
We provide direct evidence in humans that TES with a 4 × 1-Ring configuration can activate motor cortex and that current does not substantially spread outside the stimulation area.
Tags: HD-tDCS, electrodes, M1

Transcranial Direct Current Stimulation (tDCS) Reduces Postsurgical Opioid Consumption in Total Knee Arthroplasty (TKA).
…tDCS may be able to reduce post-TKA opioid requirements.
Tags: pain,

Modulating lexical and semantic processing by transcranial direct current stimulation.…(tDCS), which is applied over Wernicke’s area and its right homologue, to influence lexical decisions and semantic priming…
Results showed impaired lexical processing under right anodal/left cathodal stimulation in comparison with sham and left anodal/right cathodal stimulation.

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:

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]
Thanks Jim!

Efficacy of Transcranial Direct Current Stimulation and Repetitive Transcranial Magnetic Stimulation for Treating Fibromyalgia Syndrome: A Systematic Review – Marlow – 2012 – Pain Practice – Wiley Online Library

Conclusion:  Studies involving excitatory rTMS/tDCS at M1 showed analogous pain reductions as well as considerably fewer side effects compared to FDA approved FMS pharmaceuticals. The most commonly reported side effects were mild, including transient headaches and scalp discomforts at the stimulation site. Yearly use of rTMS/tDCS regimens appears costly $11,740 to 14,507/year; however, analyses to appropriately weigh these costs against clinical and quality of life benefits for patients with FMS are lacking. Consequently, rTMS/tDCS should be considered when treating patients with FMS, particularly those who are unable to find adequate symptom relief with other therapies. Further work into optimal stimulation parameters and standardized outcome measures is needed to clarify associated efficacy and effectiveness.

via Efficacy of Transcranial Direct Current Stimulation and Repetitive Transcranial Magnetic Stimulation for Treating Fibromyalgia Syndrome: A Systematic Review – Marlow – 2012 – Pain Practice – Wiley Online Library.