Dr. Felipe Fregni is the director of the Laboratory of Neuromodulation and Center of Clinical Research Training. He is an Associate Professor at Harvard Medical School of Neurology and Physical Medicine & Rehabilitation, and an active clinical researcher and educator. In this episode, Dr. Fregni talks about his research into the use and benefits of Transcranial Direct Current Stimulation (tDCS).
http://smartdrugsmarts.com/dr-felipe-fregni-transcranial-direct-current-stimulation/ Download: mp3
Known as transcranial direct current stimulation (tDCS), the process involves attaching electrodes to the skull and targeting specific areas of the brain with calculated jolts of electricity.
“The brain is an electrical organ, so it makes sense to try to manipulate what’s going on in the brain with electricity,” explains neuroscientist Dr. Michael Weisend.
Thync recently announced $13 million in venture capital from investors such as Khosla Ventures to bring the first products to market.
Marom Bikson, a professor of biomedical engineering at City College of New York, recently used a prototype of Thync’s device in a 100-person study funded by the company that focused on its calming effects. Bikson says the study showed “with a high degree of confidence” that the device has an effect, although the results varied. “For some people—not everyone—the effect is really profound,” he says. “Within minutes, they’re feeling significantly different in a way that is as powerful as anything else I could imagine short of a narcotic.”
The device uses a form of transcranial direct current stimulation TDCS, something that’s been tested in various forms for years but has yet to be approved by the U.S. Food and Drug Administration to treat a specific disease.
In Thync’s device, a barely perceptible electrical current is applied to the skin just behind the ear for the Red Bull effect, and on the temple and back of the neck for the relaxing effect.
via Tap Your Smartphone, Zap Your Head, and Relax | MIT Technology Review.
Methods
In two separate but closely related sham-controlled experiments, two groups of healthy subjects underwent anodal tDCS (2mA) of the left dorsolateral prefrontal cortex (DLPFC) for 20 minutes. In Experiment 1, subjects (n=11) trained on a letter 3Back task during stimulation. In Experiment 2 subjects (n=11) trained on a letter 1Back task, which resembled the 3Back task but featured a lower working memory load. In both experiments, before and after stimulation, subjects completed an adjusting Paced Auditory Serial Addition Task (A-PASAT). Both the experimenter and subjects were blind to stimulation conditions in both experiments.
Results
Subjects were both faster and more accurate on the A-PASAT task after receiving real tDCS paired with 3Back training (Experiment1) compared to sham+3Back, real+1Back, and sham+1Back conditions.
Conclusions
The cognitive demands of a task performed during tDCS can influence the effects of tDCS on post-stimulation performance. This finding has direct relevance to the use of tDCS as an investigative tool in cognitive neuroscience and as a therapy.
Even though measuring from cranial landmarks is one way to find these points, I always question measuring on the head, or body, because of the size differences between people. Hence to make it easier to locate the points, below are numerous pictures.
Left Anode Dorsolateral Prefrontal Cortex (DLPFC)
The left is obviously the left side of the head, and the anode is the more positive of the two leads (green wire on the Cognitive kit); current goes from electronics to anode through the head to cathode back to the electronics. For the position of the DLPFC, check out the cranium below:And on me pointing and with a sponge electrode(see there is an advantage to having little hair, better tDCS montage location and better electrode connection).
The final thing I wanted to test was electric shocks. Is it safe to shock your brain? For some years scientists have been using tDCS (transcranial direct current stimulation, a small electrical charge to the skull) to try to improve a whole range of things, from learning to reaction times.
Dr Charlotte Stagg of Oxford University, has been using it to help people recover strength in their hands after a stroke. Charlotte has found that, compared with a sham treatment, tDCS seems to speed up recovery, probably because of the effect that tiny electric currents have on neuronal connections inside the brain.
To see what effect it would have on me, Dr Stagg carefully positioned some electrodes on my skull and turned on the machine.
There was a slight itchiness and it did feel as if my brain had been given a jolt, but had it actually made any difference?
The short answer is yes. In a test which involved pressing a button when I saw a light go on, my reaction times improved from an average of 650 milliseconds before the machine was turned on, to 550 milliseconds with it on. These findings are in line with results from other subjects.
Depending on where he puts the electrodes, Whitmore says, he has expanded his memory, improved his math skills and solved previously intractable problems. The 22-year-old, a researcher in a National Institute on Aging neuroscience lab in Baltimore, writes computer programs in his spare time. When he attaches an electrode to a spot on his forehead, his brain goes into a “flow state,” he says, where tricky coding solutions appear effortlessly. “It’s like the computer is programming itself.”
Whitmore no longer asks a friend to keep him company while he plugs in, but he is far from alone. The movement to use electricity to change the brain, while still relatively fringe, appears to be growing, as evidenced by a steady increase in active participants in an online brain-hacking message board that Whitmore moderates. This do-it-yourself community, some of whom make their own devices, includes people who want to get better test scores or crush the competition in video games as well as people struggling with depression and chronic pain, Whitmore says.
via At-home brain stimulation gaining followers | Science News.
Excellent study. Confirming once again how early we are in our understanding of tDCS. (emphasis below are mine).
Although these studies all report positive findings there is still considerable variability in terms of the pattern of effects, paradigms used and tDCS parameters. For instance, stimulus intensity, duration, tDCS electrode montage are inconsistent. The most consistent pattern in the published literature has been to report significant improvements in WM tested in verbal n-back tasks and anodal tDCS to the left DLPFC. In other cognitive realms a patchwork of findings is emerging revealing consistent effects in memory, deception, and cognitive control. However, there are exceptions and forays into different tasks, populations, and parameters have produced different patterns of results.
via Hits and misses: leveraging tDCS to advance cognitive research.
OSB: What is the aim of your new trial?
JC: In this study, we want to see how the effects of a brief course of fluency therapy might be increased or prolonged by using TDCS. We will use some techniques that we know will immediately increase fluency in most people who stammer, such as speaking in unison with another person or in time with a metronome. However, these techniques would normally need to be combined with other methods to help transfer this fluency into everyday speech. We will investigate how TDCS might help maintain the fluent speech that is produced using these methods.
OSB: What will volunteers be asked to do?
JC: Volunteers will be invited to have fluency therapy over five consecutive days, whilst receiving TDCS. In order to measure the effects of this intervention, they will also be asked to do some speech tasks before the fluency therapy, one week after the fluency therapy, and again six weeks later. We are also interested in how this combination of therapy and TDCS may change brain function and structure. So, volunteers will also be invited for MRI scans before and after the therapy.
via Brain stimulation for your stammer | University of Oxford.
Emphasis mine on “but over time it will also gradually rewire your neurons to prevent future attacks.” Very interesting considering the source, Marom Bickson. If you’ve been following the pop press on brain plasticity, you’ve certainly heard the phrase: “Neurons that fire together, wire together.” Could this be a meta-framework for thinking about tDCS?
Head band and controller sourced from CaputronMedical.com the green electrode/strap on the right is the Soterix EasyStrap (see below)
Future medications for brain disorders could be delivered through electrodes rather than pills
By Marom Bikson and Peter ToshevThe pharmacist guides you to a shelf of headgear, labeled
with different brain regions. She fits you for a cap, the underside of which features thin conductive metal strips, called electrodes, coated in adhesive gel to stick gently to your scalp.
The electrodes link to a slim cable that dangles from the back of the cap. She then hands over the key component of your prescribed medication: an electric stimulator.
Once a day for the next week you will don the headgear
and plug the cable into this device for a 20-minute dose of
electricity. Setting aside your trepidation, you give it a try in front of the pharmacist. At first you feel only a tingling sensation and then relief.
As you wear the cap, an electric current is traveling from
the electrodes, past hair, scalp and bone, into the brain regions responsible for your migraines. At first it merely blunts the pain, but over time it will also gradually rewire your neurons to prevent future attacks. The pharmacist explains that you will be free to carry on with your day—finish chores, watch television, go for a walk– with the cap on your head, and when the dose is up, the stimulator will simply stop running.
——–
When brain cells activate together, the connections among them grow stronger and more numerous. Cells that seldom fire in concert gradually lose their linkages. Adding tDCS can therefore heighten the brain’s ability to rewire itself—its plasticity.
Source: http://neuralengr.com/wp-content/uploads/2014/10/samind_2014_11.pdf
See also: Zap Your Brain to Health with an Electrode Cap – Scientific American.
And: Giving the Brain a Buzz: The Ultimate in Self-Help or a Dangerous Distraction?
Soterix Accessories page. (I am not affiliated with Soterix or any other product mentioned on this blog).
For years we heard about ‘right brain’ vs. ‘left brain’ thinking. Now that that is turning out to be a myth I’m seeing more and more references to brain networks. And as it applies to tDCS we’re hearing about accessing regions of the brain previously thought to be inaccessible via surface electrodes.
In this excellent research, Michael D. Fox (et al) access entire networks via a single node and beg the question, why Deep Brain Stimulation (a tricky and risky surgical procedure) when we can access the same networks through non-invasive stimulation (tDCS, TMS etc).
In this article, we identify diseases treated with both types of stimulation, list the stimulation sites thought to be most effective in each disease, and test the hypothesis that these sites are different nodes within the same brain network as defined by resting-state functional-connectivity MRI.
…
In both cases, the effects of stimulation propagate beyond the stimulation site to impact a distributed set of connected brain regions (i.e., a brain network). Given increasing evidence that these network effects are relevant to therapeutic response, it is possible that invasive and noninvasive stimulation of different brain regions actually modify the same brain network to provide therapeutic benefit.
One unusually well-designed study, he said, was from the University of Lyon in France, in which 30 people with schizophrenia reported that after TDCS, they heard voices about 30 percent less than before. The researchers followed up with the patients, and the treatment was still working, even after three months.
Frohlich decided that the schizophrenia study was so potentially life-changing for patients that it had to be replicated — and improved upon — as quickly as possible. According to the National Institutes of Health, about 1 percent of Americans have schizophrenia; many of them are too sick to work or even talk lucidly with their doctors about treatment. Antipsychotic medication helps some, but it has serious side effects. A 2013 study estimated that the costs of schizophrenia — from treatment to caregiving and unemployment — are about $4 billion a year in the U.S.
When I started this blog in 2012 friends and family thought I was crazy. But I knew something interesting was happening and now that we’re seeing all this VC money flowing into the space it’s obvious something IS happening. Still too early to tell what will become of all this, but a single ‘killer app’ (provable, repeatable, without side-effects) could launch tDCS, or another form of non-invasive brain stimulation, into the mainstream.
I wonder if Thync’s announcement took Halo Neuroscience by surprise (probably not). Considering how simple a tDCS device is to make, it will be interesting to see if add-ons can make individual devices truly patentable – I’m thinking built-in feedback and monitoring etc.
And this on Thync’s About page from Marom Bikson! This is interesting in itself because Dr. Bikson has been critical of efforts to commercialize tDCS in the consumer space (especially the foc.us device, but generally cautious)
“Dr. Jamie Tyler has built an extraordinary team of scientists and engineers at Thync who are creating consumer devices that achieve a level of neuromodulation performance, safety, and ease-of-use that is a categorical advance for the field.”
Looking into the list of scientific publications Thync lists on their site, I would have to conclude that perhaps their focus is more on transcranial pulsed ultrasound (TPU) than tDCS. And look! DARPA has also been funding research in TPU. [Update: Thync confirmed their first device will be tDCS based.]
Thync @thync
@DIYtDCS Thank you for the inquiry. We have deep knowledge of both. Our first product will be around #tDCS.
Here, from Thync’s website, they lay out the technological foundation of their ‘Vibes’ product.
We have developed proprietary neurosignaling waveforms that target neural pathways via a mechanistic triad:
• BRAIN: prefrontal and frontoparietal brain regions
• NERVES: sensory fibers of cranial nerves
• MUSCLE: neuromuscular fibers
And…
Aha! From a Business Week article tweeted by Marom Bikson, (implying their device, at least initially is more likely to be tDCS based):
Thync pursued Tyler’s ultrasound techniques for the first year, until the founders learned about studies conducted at the Wright-Patterson Air Force Base in Dayton, where researchers had tried to improve pilots’ cognitive abilities with electrical stimulation. Reasoning that the electrical method, with its rapidly improving science, offered a safer, quicker route to the market, Thync switched gears. Since then, the company has worked to shrink the electrodes and develop its algorithms to produce a reliable, comfortable experience.
For the past 18 months, Thync has tested its “vibes” on more than 2,000 people in clinical trials at its Boston office and the City College of New York. Some subjects didn’t respond to the treatment at all—it doesn’t work for everybody—but the company reached a milestone when two out of three respondents started to regularly say the sensations were more powerful than the placebo effect. “Most people rate it as a moderate to strong response,” Goldwasser says of the energy vibe, “or at least as good as a few cups of coffee.”
Prof. Bikson is co-director of Neural Engineering at The City College of New York so it stands to reason he was involved in the testing. When I asked him via Twitter he said:
Marom Bikson @MaromBikson
DIYtDCS CCNY completed 90 subject 6-week (5 session per week) trial using Thync and Soterix tech. Exciting details and results coming soon.
Excited to see the results of these tests. Also, as long as we are heading into the consumer space, it’s great to have Dr. Bikson involved.
The product is set to launch in 2015. I’ll be following closely…
Update 10/12/14 Following up on Mika’s observation (see comments)…
@DIYtDCS Neurotrek was our initial company name before becoming Thync. However, we have no relation to any Neurotrek CES products.
P.S. Thync hit it out of the park with the naming of their company/domain/Twitter handle.
See Also:
Thync Lets You Give Your Mind a Jolt
Thync’s Wearable Won’t Just Measure Your Mood, It Will Fix It – IEEE Spectrum.
Thync to Launch First Mood-Altering Wearable With $13M Led by Khosla
Thync Has Raised $13M To Change Your Mood With Ultrasound Waves (And Electricity)
Wearable tech to hack your brain | CNNTech 10/23/14
“We wanted to test the hypothesis that these various stimulation sites are actually different spots within the same brain network,” explains Fox. “To examine the connectivity from any one site to other brain regions, we used a data base of functional MRI images and a technique that enables you to see correlations in spontaneous brain activity.” From these correlations, the investigators were able to create a map of connections from deep brain stimulation sites to the surface of the brain. When they compared this map to sites on the brain surface that work for noninvasive brain stimulation, the two matched.
via New clues revealed to understand brain stimulation — ScienceDaily.
Can’t vouch for the veracity of this diagram, but I like the format of the information and hope we can evolve a useful diagram that would also track (link to) specific tDCS studies that confirm the relationship of electrode-placement/brain-function. Via Reddit User cellavy
Thync