tDCS For The Masses – Foc.us ‘Go Flow’

Update 2/29/16 Some details of operation I borrowed from the Foc.us rep on the tDCS subReddit.

Yes, you can do any combination of time and current between the minimum and maximum limits.

The current level can be set from 0.5mA to 2mA, and is indicated with ORANGE lights. Pushing up or down the rocker will change the value in 0.25mA steps. e.g. 0.5, 0.75, 1.0, 1.25, 1.5, 1.75, 2mA.

Once the current is set the lights change to GREEN. This is to set the time and pushing the rocker up or down will change in increments of 5 mins e..g. 5, 10, etc.. to a maximum of 35 mins.

Once you press to confirm the time the session will start. There is a slow ramp-up of current at session start for comfort. The gauge will now change from ORANGE to GREEN every 5 seconds.

During an active session the lights will show you the actual current value or approximate time remaining. Using the same Orange for current and green for duration scales.

If you find the current level too low or too high, you can change it during an active session. Simply press the rocker up or down – but please note the current will be ramped for comfort, so wait for each change to take effect. The lights will instantly change to orange to show you your changed level.

Changing current during active sessions is in 0.125mA steps for fine grained control and accuracy. You can see these hard steps by half lit lights. The current level shown on the ORANGE display is the actual, accurate current.

You can click the rocker during an active session to stop and the current will ramp down and off.

“Does it taper down the current over time, or will it be at a constant current over time?” no, this device will not give you incorrect current, neither too low, nor too high. It will be accurate from start to stop. It will not fail just because you have used the wrong amount of salt or your own choice of electrodes or any of the other things that trip up other devices. If for any reason the device detects it cannot maintain the target current, the LEDs will flash green/orange and the session will be stopped.

At focus we believe that the first job of a current stimulator is to produce an accurate safe current. It is staggering that this is considered optional by other manufacturers.

I think you’ll find its a really simple device to use and operate.
If it flashes orange and green – that means the headset is not connected. If it flashes just orange, that means it cannot reach even 0.5mA. This means the resistance somewhere is too high, usually the pads. Please try with fresh pads and problem should be gone.

Update 1/22/16: Part ll of Brent Williams GoFlow review focuses on choosing electrodes.
Update 1/21/16:  Brent Williams has just published a review of the GoFlow with how-to details The Brain Hacking Revolution Continues: Introducing the foc.us Go Flow – Part 1

Not shipping until March but now taking pre-orders, Now shipping. Foc.us ‘Go Flow’ tDCS device comes in at under $30 including cables and electrodes (hydrogel only for now). But you can purchase the device itself (and use your own electrodes) for less than $15.

Read the ‘Go Flow’ story here: The Story of Focus Go Flow or order one for yourself here: FOCUS Go Flow tDCS Brain Stimulator

20160105focusGoFlow

Adam Gazzaley | ShrinkrapRadio.com

Adam Gazzaley TedX Sonoma 2015

Adam Gazzaley TedX Sonoma 2015

We’ve covered Dr. Adam Gazzaley director of the Gazzaley Lab at UCSF previously so I was excited to see he was being interviewed for one of my favorite podcasts, ShrinkrapRadio by Dr. David Van Nuys. I’m a big fan of Dr. Dave and have been enjoying his interviews with top psychologists for years. (Especially those with Jungian analysts.) I’ve clipped an excerpt of the interview that deals directly with tDCS and brain stimulation below but I highly recommend checking out the entire episode as it provides an excellent framework for understanding the notion of brain training using technology including video games designed specifically to enhance memory and cognition.

In this clip Dr. Gazzaley lays out what clearly is the near-future of non-invasive brain stimulation… You’re playing a video game that has been optimized to enhance working memory (for example). At the same time your EEG is being monitored for brain activity. According to the EEG data, tDCS (tACS, tRNS etc) is activated for the purpose of enhancing activity in that region of your brain. As your game accuracy increases, the game adapts to increase difficulty to an optimum training level. Loop!

Here’s a 2 minute clip from Dr. Dave’s interview with Adam Gazzaley

Dr. Gazzaley’s (@adamgazz co-founder with @EddieMartucci) company, Akili (@AkiliLabs), just announced (1/22/16)  $30.5 million in funding. Interesting, Akili is part of the PureTech (@PureTechH) family of companies we covered recently (Tal Medical).

A few of Dr. Gazzaley’s papers you might find interesting.
Video game training enhances cognitive control in older adults Nature (pdf)
Effects of noninvasive brain stimulation on cognitive function in healthy aging and Alzheimer’s disease: a systematic review and meta-analysis. (pdf)

Dr Gazzaley’s  (Nov 2015) Ted Talk

Low Field Magnetic Stimulation

All roads LFMS lead to the Harvard Low Field Magnetic Stimulation Lab. But please follow along with what led me here in the story below.

Harvard's Low Field Magnetic Stimulation Lab

Harvard’s Low Field Magnetic Stimulation Lab

I came across Low Field Magnetic Stimulation, or LFMS, in a recent panel talk from SXSW: Superbugs, Magnets & More: Medicine’s Comeback Kids – SXSW Interactive 2015. The conversation is particularly interesting considering panelist Dr. Bennett Shapiro’s background. At Merck he led research that developed over 25 drugs and vaccines. (The panel touches on magnets, phage therapy and fecal transplants, for example.)

Dr. Shapiro’s company (he is the co-founder and non-executive director), Pure Tech Health created Tal Medical, to develop an LFMS treatment/device.
This is most likely the nexus for looking into LFMS in the first place:

Anecdotal reports have suggested mood improvement in patients with bipolar disorder immediately after they underwent an echo-planar magnetic resonance spectroscopic imaging (EP-MRSI)… Low-Field Magnetic Stimulation in Bipolar Depression Using an MRI-Based Stimulator  (Found on the Tal Medical publications page.)

The panel discusses TMS, which has recently been approved by the FDA for treatment of depression. But Dr. Shapiro goes on to discuss LFMS, which (to my readers anyway) is especially interesting because it uses so little power to achieve its effects. (As opposed to TMS which is too complicated and powerful to ever become part of the DIY community. Never say never!)

In 2013, Tal received initial proof-of-concept data from a randomized, double-blind, sham-controlled trial in patients with major depressive and bipolar disorders conducted by McLean Hospital, a leading psychiatric research hospital affiliated with Harvard Medical School. In the study, a single 20-minute treatment demonstrated rapid onset of action, substantial effect size, and a strong safety profile. Given this unique, rapid effect of LFMS treatment, the National Institute of Mental Health has selected LFMS for a multi-site clinical trial. The trial is examining the efficacy and durability of the treatment over an extended period of time in patients with major depressive disorder.

Researching possible patents led to Michael Rohan, Ph.D. and the Harvard Low Field Magnetic Stimulation Lab. I assume there is a partnership between the Harvard Lab, McLean Hospital and Tal Medical, though I could not find any formal announcement. Click through the lab link to do a deeper dive into ongoing research they are presently involved with, including clinical trials.

Unlocking the Brain with New Stimulation Technologies | Medium

Excerpt from an interview with clinical neuroscientist, Kate Hoy. The paper referenced is Testing the limits: Investigating the effect of tDCS dose on working memory enhancement in healthy controls

What is the most surprising or interesting research case you have worked on?

The findings where the data doesn’t show what you expected are always the ones that mean the most. In one study we were looking at the effect of gentle electrical stimulation (tDCS) on memory in healthy people; we compared sham (‘fake’) stimulation with a low and a high dose of tDCS. My hypothesis was that the higher the dose the better would be the performance and I couldn’t have been more wrong. The findings showed that the sham stimulation did nothing (as predicted), the low dose improved performance significantly, and the high dose behaved most similar to the sham stimulation.

This puzzled us so we brainstormed the findings and came back to the idea of homeostasis, where you can push the healthy brain a little but if you push it too much it will ‘push back’. Essentially, there are only limited gains in brain function that can be achieved in the healthy brain. That finding, which was from an Honours project, that I had initially worried was uninterpretable, resulted in a publication, two current PhD projects, and set me off on a different path with this aspect of my research.

Older adults get episodic memory boosting from noninvasive stimulation of prefrontal cortex during learning

Great example of exactly what we’re up against. The study in the previous post found no effect on Working Memory in older adults targeting dorsolateral prefrontal cortex (dlPFC). This study did find a positive effect on Episodic Memory in older adults targeting left lateral prefrontal cortex (PFC).

Episodic memory displays the largest degree of age-related decline, a process that is accelerated in pathological conditions like amnestic Mild Cognitive Impairment (aMCI) and Alzheimer’s Disease (AD). Previous studies have shown that the left lateral prefrontal cortex (PFC) contributes to the encoding of episodic memories along the life span. The aim of this randomized, double-blind, placebo-controlled study was to test the hypothesis that anodal tDCS over the left lateral PFC during the learning phase would enhance delayed recall of verbal episodic memories in elderly individuals. Older adults learned a list of words while receiving anodal or placebo (sham) tDCS. Memory recall was tested 48 hours and 1 month later. The results showed that anodal tDCS strengthened episodic memories, an effect indicated by enhanced delayed recall (48 hours) compared to placebo stimulation (Cohen’s d effect size=1.01). The observation that PFC-tDCS during learning can boost verbal episodic memory in the elderly opens up the possibility to design specific neurorehabilitation protocols targeted to conditions that affect episodic memory such as MCI.