Brain Zapping

Image: Foc.us

Photo by Foc.us

“ELECTROCEUTICAL” DEVICES THAT USE electrical currents from batteries or magnets – many outside the body — promise improvements in learning, attention, creativity, memory including recall of proper names, and reading efficiency as well as boosting the brain’s plasticity. In addition, these devices can relieve chronic pain, depression and fatigue, and treat tinnitus, PTSD, autism, addiction and bladder issues. And the list goes on.

For serious, intractable conditions, implanted devices provide deep brain stimulation (DBS) to relieve symptoms of severe depression and Parkinson’s disease; vagus nerve simulation (VNS) to treat autism and severe depression; and sacral nerve stimulation to improve bladder and bowel control. According to the International Neuromodulation Society, the most common of these treatments is spinal cord stimulation (SCS) for chronic neuropathic pain.

More recently, external devices – some of which can be purchased online or made at home for about $50 — provide “therapeutic neuromodulation,” altering nerve activity in the brain and elsewhere in the body, in the same way that electro-convulsive therapy (ECT) is used to treat severe depression, but at much lower doses.

As a brain-zapper, the “transcranial direct current stimulation” (tDCS) headset transmits low doses of electricity into the brain. DCS is thought to create or strengthen neural pathways in the same way that repetitive practice – swinging a tennis racquet or speaking a foreign language – eventually makes a behavior more automatic, and works best if used while practicing the desired skill. Biomedical engineer Marom Bikson at the City College of New York considers tDCS a way to “make the brain function more effectively, or improve plasticity and make it more able to learn…you sort of prime the brain” for whatever training or treatment you are undergoing.

The Foc.us device, marketed originally for video gamers, has been available for several years, costing from about $250 to $300; the first production run of 3,000 sold out in less than a month. One reviewer noted that “the general feeling of alertness was indisputable,” and other fans claim the device improves reaction time, mood, computational ability and memory, writes Kate Murphy in The New York Times.

The soon-to-be-marketed Thync apparatus claims “to bypass the brain and instead use pulsed currents to stimulate peripheral nerves closer to the surface of the skin,” according to Kira Peikoff in The New York Times. Thync company representatives say their product will produce “calm vibes” greater than that produced by taking three Benadryls, and “energy vibes” stronger than drinking a 20-ounce can of Red Bull. Both kinds of vibes last about 45 minutes with no subsequent crash.

DCS is already being used to train drone pilots. In a study using software called “Vigilant Spirit,” sleep-deprived volunteers spent hours looking at images of a crowded village square trying to identify people carrying guns: those who received DCS performed about twice as well as those who had caffeine or no stimulation, and the effect lasted about three times as long as caffeine. Most DYIers assemble their own “transcranial stimulators” using nine-volt batteries to use while playing video games; most are male, with a wide range of ages.

Another kind of neuromodulator uses pulsed energy from magnetic coils — called “magnetic resonance therapy” (tMRT) or transcranial magnetic stimulation (TMS) — to realign and synchronize the firing of neurons depending on the condition to be treated, similar to an MRI, which uses much stronger pulses of energy. FDA-approved for drug-resistant major depression, MRT has been used by The Brain Treatment Center in Newport Beach, California for more than 1,000 patients, the majority for autism – in previous studies, it helped about 90 percent of cases. The Newport Beach center has also used MRT for Alzheimer’s disease, addiction, anxiety and sleep and eating disorders. Of more than 100 veterans treated there for PTSD, “one hundred percent responded with very visible change,” according to the center’s medical director Yi Jin. One vet described the experience as taking a 10-minute nap and feeling as if he’d slept 16 hours!

While an array of companies are leaping ahead to produce and market these devices, the medical community remains hesitant. Dr. Roy Cohen Kadosh, neurologist at the University of Oxford,  believes that at the right intensity and timing, tDCS can improve cognitive abilities including attention. But he cautions: “You need to know how long to stimulate… and what intensity to use.” The dose can vary depending on age, sex, and other drugs such as antidepressants being taken, as well as the thickness of the skull and hair.

Others point to the dearth of controlled studies, to the possibility of effects accumulating over time with unknown long-term consequences, and to the question about whether you’re zapping your brain in the best location. Most worrisome is whether enhancing mental function in one area can have a negative impact on another: one study showed improving some math skills made other skills deteriorate. Users have complained of temporary side-effects including discomfort or burn where the magnets or electrodes are placed, mild headaches, lightheadedness, and irritability. People with epilepsy should not use these devices.

One better-accepted use of neuromodulation is for treating bladder problems, such as “urge incontinence,” which involves inserting a slim needle – very carefully, in a neurologist’s office — into the heel near the tibial nerve, from which an electrode sends impulses up the leg to the sacral area responsible for bladder control. Marketed by Uroplasty, Inc., the “Urgent PC” procedure takes 30 minutes and is performed in a series of 12 treatments – although a patient of Chevy Chase neurologist Mary Dupont reported some improvement in urgency after a few sessions and a “complete cure” after only eight. According to Uroplasty, Inc. more than 80 percent of patients have a positive response; and in a double-blind placebo study, 71 percent of patients had a greater than 50 percent reduction in “voids per day.”

A remaining mystery about neuromodulation: why some uses must be accompanied by cognitive tasks, such as working on math problems, while others do not. According to the New Yorker article, ”Electrified,” tDCS  “makes depressed people feel better even if they’re just sitting there.”

–Mary Carpenter

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