Brain Stimulation Clinic
tDCS: Transcranial Direct Current Stimulation
Transcranial Direct Current Stimulation (tDCS) is a safe, non-invasive therapy for treatment-resistant neurologic, psychiatric and chronic pain disorders. Also, you can increase memory and learning with tDCS. Effective, easy-to-do, inexpensive and without side effects, tDCS can be done in the outpatient clinic or, for the appropriate patient, in the home which provides obvious advantages. tDCS can be done as an add-on or adjuvant procedure and as a stand-alone protocol. tDCS provides benefit for patients who inadequately respond to conventional treatments and improves learning for patients with disabilities
tDCS is beautiful in its simplicity. tDCS utilizes a weak, direct electrical current to generate an electrical field which modulates the activity and excitability of neurons of targeted areas of the brain to produce clinical results. tDCS is a technique used to affect brain plasticity which is the ability of the nervous system to change functionally and structurally.
tDCS provides relief for chronic pain (migraine, fibromyalgia, neuropathic pain, complex regional pain syndrome,temporomandibular joint disfunction and pelvic pain), depression, bipolar disorder, tinnitus, stroke and the addictions. tDCS also improves cognitive functioning, memory and learning, especially in those with disabilities. tDCS is an exciting new technique and can be coupled with pharmacological and behavioral approaches.
tDCS is easy-to-do. Moist sponge electrodes are placed on the scalp and held in place with an elastic headband, overlying the targeted areas of the brain. There is no perceptible sensation or only a slight tingling under the electrode.The patient is comfortably sitting or lying down.
tDCS is performed in the outpatient clinic or for select patients may be done at their home.
tDCS: Mechnism of Action
tDCS is a technique of neuromodulation. tDCS involves passing an imperceptibly weak, (1 milliamp, 1/1000 of an amp) direct current to the brain, delivered by two sponge electrodes on the skin to influence brain function. The current passes from the anodal to the cathodal electrode. The area of the brain under the anode (+) is facilitated and the area under the cathode (-) is inhibited. Transcranial direct current stimulation is site-specific and is used to up-modulate or down-regulate targeted areas the brain. Besides inducing excitability changes during the stimulation, tDCS can evoke prolonged modulation of neural activity persisting after the direct current offset. The prolonged after-effects induced by tDCS are the basis of its therapeutic use. tDCS influences neuronal function by several different mechanisms including changes of synaptic activity, modulation of membrane function outside the synaptic cleft, changes of vascular motility and reactivity, and neurochemical changes below the stimulating electrodes. The tDCS induced inhibition or excitation persists beyond the period of stimulation, resulting in therapeutic changes that can endure for weeks, months or longer.
tDCS compared to rTMS
Whereas tDCS delivers low-intensity electrical current to the scalp and underlying brain, repetitive transcranial magnetic stimulation (rTMS) utilizes electromagnetic induction to generate electric currents in the brain. In general, low-frequency rTMS and cathodal tDCS reduce, and high-frequency rTMS anodal tDCS enhance excitability in the targeted cortical region. Both rTMS and tDCS promote snaptic plasticity, specifically long-term potentiation (LTP) and long-term depression and lead to the same result.
Compared to rTMS, tDCS has advantages. tDCS is simple, inexpensive, painless and can produce effects of opposite direction (facilitation or inhibition) on different parts of the brain. Also, tDCS can be used simultaneously with cognitive training, as it produces much less scalp sensation than rTMS.
Because of the electrode size, tDCS is less focal than rTMS. On the other hand, the relatively large size of the electrodes results in a greater likelihood the targeted area will be stimulated.
tDCS is not ECT
tDCS should not be confused with electroconvulsive or shock therapy (ECT), where a much larger current of 600-1000 milliamps is applied to the entire brain. ECT is designed to trigger a grand mal seizure and must be done under a general anaesthetic. Multiple induced seizures can relieve symptoms of severe depression. ECT has significant side-effects, including memory loss and confusion, and so it is only utilized for patients with severe treatment-resistant depression.
Undesirable side effects of tDCS are limited to reddening or irritation of the skin underlying the electrodes. This is eliminated or significantly reduced by saturating the sponges with saline. There is no injury or harm to the brain. An extremely wide margin of safety is present based on laboratory, clinical and calculation studies.
The mission of the Brain Stimulation Clinic is to provide transcranial direct current stimulation to patients who are treatment-resistant to traditional and conventional therapies. The Brain Stimulation Clinic strives to make tDCS therapy accessable and affordable for the suffering, treatment-refractory patient.
Clinical Application of tDCS
tDCS has demonstrated benefit for the relief of chronic pain syndromes including:
- stroke pain
- neuropathic pain
- complex regional pain
- temporomandibular joint disorder
- migraine headache
- chronic daily headache
- post-stroke pain
- central pain syndrome
- multiple sclerosis pain
tDCS provides relief for:
- stroke recovery
- cognitive function
- motor memory