Weekend tDCS Insights – Chi & Snyder, SpeakWisdom, Carlo Miniussi

Some very excellent tDCS-related documents came to my attention over the weekend. I’m pretty sure I’d looked for at least one of them before, but that it was behind a paywall. I’ll provide links to the pdfs here, but suggest that (as has happened elsewhere on the blog) pdf links frequently go bad so ‘get em while they’re hot’.

Brain stimulation enables the solution of an inherently difficult problem (pdf)
This is the paper by Alan Snyder and Richard Chi that is frequently referenced in ‘unlock your inner savant’ articles on various pop-sci sites. (See also) Spoiler alert! Gives the answer to the ‘9 dot’ problem and once you’ve seen it it will be impossible to discover how ‘savant-like’ you are (at least according to this test).

ninedot …we applied cathodal tDCS (1.6mA) at the left anterior temporal lobe (ATL) together with anodal tDCS at the right ATL for approximately 10 min… None of the 22 participants in the main experiment solved the nine-dot problem before stimulation. But with 10 min of right lat- eralizing transcranial direct current stimulation (tDCS), we found that more than 40% of participants could do so.

speakWisdomTakeapartDr. Brent Williams, at his SpeakWisdom blog, published another excellent tDCS post updating his DIY device, and adding a .doc that outlines his recommended (For Discussion) protocols for depression, ‘Savant Learning’, memorization, and chronic pain.
His protocol describes directions for use with either his ‘User-Built tDCS Research Device’, or the ActivaDose II.

Transcranial Magnetic and Electric Stimulation in Perception and Cognition Research (pdf)
This is a fascinating paper (Carlo Miniussi et al) that brings us up to date (2012) on applications of tDCS, TMS tACS (transcranial alternating current), and tRNS (transcranial random noise stimulation), especially in relation to cognition and learning. What really caught my eye was this entry about tRNS…

 tRNS consists of the application of a random electrical oscillation spectrum over the cortex. tRNS can be applied at different frequency band ranges over the entire spectrum from 0.1 to 640 Hz…They applied tRNS to the visual cortices of healthy subjects and observed a significant improvement in the performance of healthy subjects in a visual perceptual learning task. This improvement was significantly higher than the improvement obtained with anodal tDCS…

And that folks, is how a weekend disappears down the rabbit hole!

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!