Do not use the “Oreo Cookie” approach where you soak your sponge in your saline solution and squeeze it to remove the extra. Because it over saturates, it’s dripping, it’s very “subjective” and hard to reproduce. Get a syringe and put 8mL of saline solution on your sponge and make sure to also get the corners. Do that prior to insert the electrode in between the 2 layers. If it’s dripping wet, that’s bad (you’re doing it wrong!). You should not have to use a tower on the patient’s neck.
Excellent article traces the rise in tDCS interest. Includes many of the key players and links to important research papers. Do DIY Brain-Booster Devices Work?
— Esther Landhuis (@elandhuis) January 10, 2017
Analysing these high-standard studies revealed that tDCS seems to reliably improve the symptoms of depression, addiction and craving, and fibromyalgia. It also uncovered that the technique does not work for tinnitus, and that the evidence for using tDCS for stroke rehabilitation was not as strong as many had thought.
Full article: Zapping the brain really does seem to improve depression
An email from Michelle Pearson at the NIH (because I had signed up for the online version of the workshop) alerted me today to a trove of TES (Transcranial Electric Stimulation) info being made available to us. Presenter slides (in PDF form) from the workshop were available for download. Because the download process was pretty wonky, involving many clicks and declined logins to Dropbox I thought to make them available here as well.
1-lisanby-introductory-remarks Sarah Hollingsworth Lisanby, M.D., NIH
2-rumsey-introduction Judy Rumsey, Ph.D.
3-wassermann-historical-overview Eric Wassermann, M.D., NINDS
4-parra-tdcs-mechanisms Lucas Parra, co-founder of Soterix Medial Inc. @lcparra1
5-frohlich-tacs-mechanisms @FlavioFrohlich, University of North Carolina-Chapel Hill
6-clark-combining-imaging-and-stimulation Vincent P. Clark, PhD Mind Research Network
7-woods-tes-technical-aspects Adam J. Woods, PhD @adamjwoods
8-richardson-blinding Jessica D. Richardson, Ph.D.
9-kappenman-reproducibility Emily S. Kappenman
10-bikson-computational-modeling-design Marom Bikson, CCNY @MaromBikson
11-deng-anatomical-variability-efields Zhi-De Deng, Ph.D., NIH
12-dmochowski-targeted-stimulation-sources Jacek P. Dmochowski, CCNY
13-loo-depression-trials Colleen Loo, Black Dog Institute
14-brunoni-neuropsychiatry-large-trials André R. Brunoni, @abrunoni
15-cohen-motor-learning Leonardo G. Cohen, M.D. NINDS
16-edwards-augmentation-neurorehabilitation Dylan J. Edwards PhD
17-lim-ongoing-trials Kelvin O. Lim, M.D.
19-charvet_remote-tdcs Leigh Charvet PhD, NYU
Marom Bikson (no less!) demonstrating depression montage using the Soterix EasyStrap.
tDCS montage for depression multi-center trial. EasyStrap nicely secures rivet electrodes without obscuring contact. pic.twitter.com/IyUajrKqlr
— Marom Bikson (@MaromBikson) March 17, 2016
Another view of tDCS depression montage by EasyStrap. Note ruler, even electrode contact and access for adjustment. pic.twitter.com/Nb0GaPXX6c
— Marom Bikson (@MaromBikson) March 17, 2016
From a recent Marom Bikson slide deck (pdf).
Revisiting this post from a few months ago because as I slowly wade through these state-of-the-art brain stimulation presentations from the leading scientists in the field, I’m discovering a lot of new information that is not generally known or being discussed. For example, in this talk ‘BrainSTIM2015 – Physiology and functional effects of tDCS and related techniques’, Michael Nitsche explores why 1mA may be a better dosage choice and also how a second session of tDCS 30 minutes after the first may lead to increased plasticity effects.
Vince Clark has just published video presentations from the recent BrainSTIM conference.
This is a real treasure trove of state-of-the-art tDCS and brain stimulation information.
Presenters: Vince Clark, Giulio Ruffini, Marom Bikson, Peter Bandettini, Michael Nitsche, Katie Witkiewitz, Peter Fox, Luke Torre-Healy, Erika Ross, Mayank Jog, Abbas Babajani-Feremi, Alexander Opitz, Mark Lowe, Hiroyuki Oya, Felipe Salinas, Shalini Narayana, Branislava Curcic-Blake, Franca Tecchio, Yuranny Cabral-Calderin.
Katie, 23, has suffered from anxiety and depression since she was 18. When her boyfriend Lee told her about transcranial directcurrent stimulation (tDCS), a form of neurostimulation which involves administering a low level of electrical current to the brain, she was sceptical. But Lee had heard that it could help people with mood disorders and wondered if she might benefit from it.
“The first time, I freaked out,” she remembers. “I thought, ‘I can’t cope with putting electrical stimulations in my brain.’ Lee put this machine on and, it’s difficult to explain, but, everything went empty in a good way. I can’t remember if I’ve ever felt like that. I felt relaxed and chilled inside. It was a mad sensation and an out-of-body experience.”
She’d tried anti-depressants in the past but found they didn’t work for her. Now she uses the kit regularly. “It’s improved my life and improved my mind,” she says.
Source: Hooking up: zapping your brain
Dr. Giulio Ruffini, “Transcranial Current Stimulation: Going Multifocal”
“…I will describe a new class of devices using multi electrode montages and small, EEG-compatible electrodes, complemented by advanced biophysical models.”
Dr. Marom Bikson, “Targeting transcranial Electrical Stimulation using EEG: The scalp space approach”
“…Next, how to optimize tES based on either evoked or spontaneous EEG recording is discussed including a novel “scalp space” approach which requires no source localization and no computational modeling.”
I see also that the The Neuroelectrics Team will be demonstrating their “latest wireless EEG (Enobio) and tCS (StarStim) technology as well as our latest StarStim Research Home Kit.
A short intro to tDCS from Marom Bikson made for the International Dose-Response Society 2014 conference.
More on tDCS (enhancing cognition) from Vincent P Clark.
Is it safe? Obviously the test wasn’t designed to assess any possible negative cognitive effects, but apart from some, “skin tingling, itching, and mild burning sensations” the subjects tolerated frequent TES (transcranial electric stimulation) well.
In the present study, we tested the tolerability (safety) and compliance, compared to sham, of two common tES approaches having a current density < 2 mA/cm2; transcranial Direct Current Stimulation (tDCS) or transcranial Pulsed Current Stimulation (tPCS) used by healthy subjects three to five days (17 – 20 minutes per day) per week for up to six weeks in a naturalistic environment. In this study 100 healthy subjects were randomized to one of three treatment groups: tDCS (n = 33), tPCS (n = 30), or sham (n = 37) and blinded to the treatment condition. The tES and sham waveforms were delivered through self-adhering electrodes on the right lateral forehead and back of the neck. We conducted 1905 treatment sessions (636 sham, 623 tDCS, and 646 tPCS sessions) on study volunteers over a six-week period. There were no serious adverse events in any treatment condition.
What a couple of days. First the New Yorker, now PBS tv! If you’re new to tDCS I’d caution you to note that Marom Bikson, one of the leading tDCS researchers in the world, is quoted below as saying ‘perhaps’, as in perhaps it improves brain function. Also, in the section where Andy McKinley is able to dramatically increase reporter Miles O’Brien’s performance of a vigilance task, ask yourself if you really have a need to improve your ‘Where’s Waldo’ score. Unfortunately, the piece doesn’t go into the use of tDCS as a tool to fight depression, which in my opinion, has come closest so far to a verifiable effect borne out by much clinical research. My point is simply that it’s early. We don’t have our tDCS ‘killer app’ yet. Stay tuned!
MILES O’BRIEN: But step aside, grande latte. There’s a new kid on the block.
MAROM BIKSON: So, current is going to come out of the device to the electrodes on your forehead and it’s going to flow through your head.
MILES O’BRIEN: Biomedical engineer Marom Bikson at the City College of New York is prepping me for a dose of transcranial direct current stimulation, or TDCS, a jump-start for my brain.
MAROM BIKSON: It can make the brain perhaps function information more effectively and therefore make you, let’s say, better at things. Or it can make the brain more likely to undergo plasticity, more malleable, more able to learn.
MILES O’BRIEN: A human brain has 100 billion nerve cells or neurons. Neurons are networkers. They make multiple connections with each other via synapses. We have about 100 trillion of them. All of this runs on electricity that we generate ourselves.
MAROM BIKSON: Now, this was the montage that we tried on you.
MILES O’BRIEN: It turns out each of our neurons is a microscopic battery with a-tenth of a volt of electricity. When we’re using them to remember things or do math or write this story, they fire electrical spikes.
MAROM BIKSON: When we’re adding electricity to the brain with TDCS, instead of a tenth of a volt, we’re producing a 1,000th-of-a-volt change, so it’s not enough to trigger a spike. It’s not enough to generate a spike, but it’s enough to modulate the spikes, to maybe get more spikes or to get less spikes.
And in this video Miles gets to fly a helicopter simulator before and after using tDCS.
How zapping his brain made Miles O’Brien a better pilot
Okay, I think we’re on the edge of a shift in thinking. Here’s prof. Bikson referring to 2mA as ‘baby aspirin’ and pointing out that ‘the dose hasn’t increased in 15 years’. Combine this with the revelation (previous post to the blog) that the Thync device is using up to 10mA (pulsed current) and that much of the experiments that went on with the Thync device were conducted by Bikson and you can’t help but conclude that researchers are ready to up the dosage. But that was one of my very first questions and I asked it far and wide, ‘Why 2mA?’.
“There’s already technology available today that can, with limited discomfort or no discomfort, deliver much higher intensities than people are using. And there’s no theoretical—not even real—reason to think that this might be hazardous,” Bikson says. “We’re at baby aspirin levels right now. [Researchers] are going really slow with this stuff.”
So why not ramp up the experiments? Researchers have to be especially cautious because of how new the science of tDCS is—and perhaps to avoid the horrors that have been observed to coincide with ECT.
“Part of the reason why people are on the fence is because the effects are small, [but] of course they’re small. The dose has not increased in 15 years,” Bikson says.
But Bikson says that might be keeping them from making real headway—and from having the sort of impact on test subjects that would get the medical community engaged with this stuff.
Very well researched and well-balanced article from Mark Harris at The Economist.
Hardly surprising, then, that DIY brain hackers want in on the action. Christopher Zobrist, a 36-year-old entrepreneur based in Vietnam, is one of them. With little vision he has been registered as blind since birth due to an hereditary condition of his optic nerve that has no established medical treatment. Mr Zobrist read a study of a different kind of transcranial stimulation (using alternating current) that had helped some glaucoma patients in Germany recover part of their vision. Despite neither the condition nor the treatment matching his own situation, Mr Zobrist decided to try tDCS in combination with a visual training app on his tablet computer. He quickly noticed improvements in his distance vision and perception of contrast. “After six months, I can see oncoming traffic two to three times farther away than before, which is very helpful when crossing busy streets,” he says.
Equally troublesome is a meta-analysis of the cognitive and behavioural effects on healthy adults that Mr Horvath subsequently carried out. As before, he included only the most reliable studies: those with a sham control group and replicated by other researchers. It left 200 studies claiming to have discovered beneficial effects on over 100 activities such as problem solving, learning, mental arithmetic, working memory and motor tasks. After his meta-analysis, however, tDCS was found to have had no significant effect on any of them.
If tDCS alters neither the physiology of the brain nor how it performs, thinks Mr Horvath, then evidence suggests it is not doing anything at all. Marom Bikson, a professor of biomedical engineering at City University of New York, disagrees. “I can literally make you fall on your butt using the ‘wrong’ type of tDCS,” he says. Dr Bikson thinks the biggest challenge for tDCS is optimising techniques, such as the dose.
via @MaromBikson Download links below.
Despite increased knowledge, and more sophisticated experimental and modeling approaches, fundamental questions remain about how electricity can interact with ongoing brain function in information processing or as a medical intervention. Specifically, what biophysical and network mechanisms allow for weak electric fields to strongly influence neuronal activity and function? How can strong and weak fields induce meaningful changes in CNS function? How do abnormal endogenous electric fields contribute to pathophysiology? Topics included in the review range from the role of field effects in cortical oscillations, transcranial electrical stimulation, deep brain stimulation, modeling of field effects, and the role of field effects in neurological diseases such as epilepsy, hemifacial spasm, trigeminal neuralgia, and multiple sclerosis.