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Brain Stimulation for the Masses

In the last decade or so there has been increasing research into non-invasive brain stimulation techniques for a variety of conditions. These include transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), random noise stimulation (tRNS), and transcranial magnetic stimulation (TMS). These techniques alter the excitability of neurons in the brain, seem to have an effect on plasticity (the ability to form new connections), and can modulate the activity of brain networks.

Overall the current research is preliminary but encouraging. Many of the details of exactly how to apply this new technology, however, are still being worked out. One recent review summarizes this complexity:

tDCS can be used to manipulate brain excitability via membrane polarisation: cathodal stimulation hyperpolarises, while anodal stimulation depolarises the resting membrane potential, whereby the induced after-effects depend on polarity, duration and intensity of the stimulation. A variety of other parameters influence tDCS effects; co-application of neuropharmacologically active drugs may most impressively prolong or even reverse stimulation effects. Transcranial alternating stimulation (tACS) and random noise stimulation (tRNS) are used to interfere with ongoing neuronal oscillations and also finally produce neuroplastic effects if applied with appropriate parameters.

In other words – exactly where the electrodes are placed on the scalp, how strong the stimulation is, how long it is applied, and the details of the pattern of electrical activity all potentially affect the net effect on brain function. Anodal tDCS stimulated neuronal firing, while cathodal tDCS inhibits function. Further, there are differences in terms of who is receiving the treatment (someone who is neurologically healthy vs. someone who recently had a stroke), and what other treatments are being given concurrently – such as physical therapy and pharmacotherapy.

Overall this does not seem like the kind of treatment that should be given over-the-counter. That is exactly what is happening, however.

For example, a product called foc.us is being sold with the following claims:

foc.us is a tDCS headset for gamers
Overclock your head!
Overclock your brain using transcranial Direct Current Stimulation (tDCS) to increase the plasticity of your brain. Make your synapses fire faster.
Faster Processor, Faster Graphics, Faster Brain!

They also address the question of whether or not the device is regulated:

No. The foc.us gamer headset offers no medical benefits, is not a medical device, and is not regulated by the FDA.

The FDA does regulate medical devices, including some cranial electrotherapy stimulation (CES) devices. But, according to the FDA, “There is no regulation for therapeutic tDCS,” which it does not consider a CES device because it is too different.

It is very problematic to claim that a device that is explicitly medical in nature is “not a medical device” simply because the claims currently being made for it are performance enhancement, rather than treating a disease or condition. This strategy does not work for drugs. I doubt the FDA would buy the argument that amphetamine is not “medical” if used for performance enhancement.

It seems to me that foc.us is exploiting the current holes in FDA regulations, which have not yet dealt with devices such as tDCS.

Regardless of regulation, I would argue that tDCS technology is not ready for the general consumer.

Effects of tDCS are promising, but largely preliminary. There are studies looking at the treatment of depression, rehabilitation from stroke, and pain relief. Results seem most encouraging for stroke recovery, less so for depression, and are leaning negative for pain relief (but again, this does not necessarily apply to all forms of brain stimulation). In all cases results should be considered preliminary.

In terms of cognitive performance, studies are again preliminary with mixed results, some showing little or no benefit.

All of the studies do tend to agree, however, that tDCS is safe. Potential side effects include local itching or tingling, headache, a burning sensation, and discomfort. However, better reporting of adverse events to more thoroughly evaluate potential side effects is also being recommended.

Conclusion

tDCS is an interesting and potentially very useful treatment designed to alter brain activity, with potential applications to depression, motor function, cognitive function, and pain. Its application is complex, however, and researchers are still working out the effects of numerous parameters.

In my opinion, tDCS is not ready for the over-the-counter market, nor the DIY community. Our knowledge base is simply not detailed enough. Further, even if we did have detailed knowledge of optimal placement, frequency, intensity, duration, etc. it would be difficult for the average user to get all these details correct. Even if these parameters could be fully automated, there is still the issue of the individual medical history of each user and how that might impact the safety and usefulness of tDCS. Meanwhile, regulations lag behind the technology and may never be aggressive.

While generally safe (although more safety data is needed), we still do not have enough information about the net effects of using this technology in various conditions for a long period of time.

It is likely that for the foreseeable future consumers will have to protect themselves from companies selling tDCS devices with unsubstantiated claims. At present I recommend caution.

Posted in: Neuroscience/Mental Health

Leave a Comment (11) ↓

11 thoughts on “Brain Stimulation for the Masses

  1. windriven says:

    Every time I think I’ve heard it all along comes a story like this. tDCS is not at this point all that much beyond making a frog cadaver’s leg twitch with a crude battery and yet we have nitwits diddling with their brain’s electronics (don’t taze me bro!) in pursuit of a half step edge in World of Warcraft. Good grief.

  2. Janet Camp says:

    Perhaps someone at the FDA should try one of these devices. Maybe (s)he will wake up enough to make the connection you point out between “medical” and “performance enhancement”.

  3. WilliamLawrenceUtridge says:

    I can’t believe anyone would think this is a good idea to try – randomly dumping enough electromagnetic energy in your brain to alter synapses just seems like a bad idea. Then again, elective trepanation is a thing, so why not compete for a Darwin award?

    1. windriven says:

      My initial response was much the same as yours. Then I asked myself the difference between experimenting with tDCS and experimenting with various psychoactive drugs, a practice not unknown to my generation in its youth. This is not to condone it at all. Simply a certain sensitivity to pots questioning the color of kettles.

      1. WilliamLawrenceUtridge says:

        Hm…drugs tend to work on single cascades of neurotransmitters, don’t they? Versus activating a relatively arbitrary area of the brain? Not to mention, this is more like experimenting with a wholly unknown psychoactive agent, not pot, heroin or cocaine. Closer to LSD just after it was discovered than the herbal agents. Anyway, I like my brain too much to randomly select it to powerful EM waves :)

        Unless we’re talking about elective trepanation? I hope we’re not, that shit’s just crazy.

  4. I had a passing interest in this at one point, at least enough to participate in a discussion where a gentleman on the Internet posted a proposed schematic for such a DIY device. I believe that the danger in the DIY community is that a VERY simple device can be made with only a few, cheap components that can all be had at any Radio Shack. This encourages people to just try things without understanding the risks. In the particular instance I’m referring to, the individual did not understand OHMs law to the point that there was no protection against over-current situations. I suggested a resister in series with the output, a very fast acting fuse, and a power source that was NOT connected to mains electricity. I was poo poo’d for being too picky.

    1. WilliamLawrenceUtridge says:

      I don’t know near enough about it to know if this is realistic or not, but theoretically couldn’t it hit just the wrong part of your brain, and either knock you out or paralyze you for sufficiently long that you could die of dehydration? Could it paralyze your breathing? I suppose you could avoid the brainstem, but still…and what actual effects would it have, a cheap, quick high?

      Anyone read Larry Niven’s Ringworld series? Remember what happened to Louis Wu in book 2? They get much better at this and we’re a step closer to orgasm hats and human extinction.

  5. qetzal says:

    I don’t think the FDA line about there being “no regulation for therapeutic tDCS” means that they consider it not a medical device. That quote comes from a section of the document where they discuss that Transcranial Magnetic Stimulation (TMS) devices are defined in 21 CFR 882.5805, Transcutaneous Electrical Nerve Stimulation (TENS) devices are defined in 21 CFR 882.5890, and Electroconvulsive therapy (ECT) devices are defined in 21 CFR 882.5940. In that context, I think they only mean that there is no analogous specific regulation that defines tDCS devices.

    This FDA page says that the definition of a medical device includes:

    an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including a component part, or accessory which is…intended to affect the structure or any function of the body of man or other animals, and which does not achieve its primary intended purposes through chemical action within or on the body of man or other animals and which is not dependent upon being metabolized for the achievement of any of its primary intended purposes.

    Seems to me that tCDS devices easily meet that definition, but I’m no expert here.

  6. Stephen H says:

    I would be interested to see if tDCS is effective in the treatment of Restless Legs Syndrome (RLS). I have tried TENS, but somehow managed to turn it up to 11 and jitterbugged for several hours. I’ve also tried all the drugs – at the moment the only thing that helps is pain relief.

    It is incredibly frustrating that you can say to someone “I have Restless Legs Syndrome” and they say “Oh, I have that. Sometimes my legs just want to move”. Well hold on, this is a condition that affects my entire life, leaves me in chronic pain, and for which I find a treatment more important than for my sleep apnoea. The name just isn’t “serious” enough (and Willis-Ekbom disease isn’t recognisable by the average joe).

    I want to believe in tDCS and TENS, but so far just haven’t seen anything to justify that hope. And in the meantime the masses are saying “all future students will NEED to use this to get good grades”.

  7. Lucario says:

    As a TCG player (mostly Pokemon) who’s always looking fr that extra edge to stay competitive, are there legitimate ways to “overclock” one’s brain and improve one’s mental/cognitive performance that don’t involve passing an electric current through one’s noggin? Bonus points if they can be done at home.

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