Umair Gaines
The brain is made up of networks of small cells called neurons that communicate electrochemically to enable us to think, feel, and interact with the world around us. Since electrical charges are responsible for brain activity, electrical stimulation can be used to change the brain's functioning. This process is called transcranial direct current stimulation (tDCS) and has been used to treat mood disorders, stress, and even help people solve problems, memorize information, and pay better attention. While tDCS has been shown to be effective in improving brain function, it can currently only access the outer layers of the brain. As such, there are still several brain functions that have not been explored with this technology.
| Characteristics | Values |
|---|---|
| Purpose | To improve brain function |
| Mechanism | Transcranial direct current stimulation (tDCS) or transcranial alternating current stimulation (tACS) |
| Function | Regulating emotions, enhancing cognitive functions (attention, learning, problem-solving, memory), treating mood disorders and stress, improving energy levels and performance |
| Application | Electrodes attached to the head transmitting low-voltage doses of electricity |
| Research | Promising findings from studies since 2013, small short-term studies showing benefits for people with depression, ADHD, and Alzheimer's disease |
| Limitations | Only accesses the outer layers of the brain, uncertainty about long-term safety, lack of reproducibility, unclear mechanism of action, potential side effects (itching, irritation, small burns, fatigue, headache) |
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What You'll Learn
Deep brain stimulation (DBS)
During DBS surgery, neurosurgeons implant one or more small wires, known as leads or electrodes, into the patient's brain. These leads are connected to a neurostimulator, a small electrical generator implanted under the collarbone, similar to a heart pacemaker. Precise placement of the electrodes is crucial for the success of DBS surgery. Microelectrode recording (MER) is a technique used to accurately identify the surgical site for implantation by visualizing and hearing neuronal activity from different brain areas.
After the surgical procedure, the neurostimulator is programmed to deliver optimal electrical stimulation. This programming process may take several appointments over weeks or months to ensure the current is properly adjusted to provide effective results. The neurostimulator runs on a battery that typically lasts three to five years.
DBS does not completely resolve the symptoms of Parkinson's disease or other conditions, but it can help reduce a patient's dependence on medications and improve their quality of life. It has also been studied for the treatment of epilepsy and Obsessive-Compulsive Disorder (OCD). However, potential side effects of DBS include cognitive impairment, memory deficits, speech difficulties, and motor disturbances.
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Transcranial direct current stimulation (tDCS)
The technique has been around for years, but its popularity has increased in the last decade. tDCS is used to treat a growing list of conditions, including depression, ADHD, and even Alzheimer's disease. It has also been shown to reduce fatigue and improve or preserve performance. In one study, service members who received tDCS in the morning were more alert and vigilant in the late afternoon than those who did not.
TDCS can be used to treat neuropathic pain after spinal cord injury, and there is some evidence that it can improve activities of daily living assessments in the short term after a stroke. It is also used to augment speech therapy for patients with acquired language disorders like aphasia.
There are some downsides to the treatment, including itching, irritation, and small burns at the sites of the electrodes. Some users also complain of fatigue or headaches. While the FDA considers tDCS safe for adults, there are no large, long-term studies, and overall safety is uncertain.
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Transcranial alternating current stimulation (tACS)
TACS is a specific version of Transcranial Direct Current Stimulation (tDCS), where the current fluctuates sinusoidally between the electrodes instead of exhibiting a constant polarity. The alternating current in tACS has a waveform that gradually changes from positive to negative voltage in each half-cycle. This allows tACS to more effectively entrain the brain's endogenous oscillations, as it mimics the alternating nature of these oscillations.
TACS can be used to modulate cortical excitability and activity, and it has been investigated as a potential therapeutic tool in psychiatry. Initial results suggest that tACS can be safe and feasible for clinical psychiatric populations, with the ability to reset disturbed brain oscillations and improve behavioural outcomes. It may also serve as a diagnostic tool to determine the prognosis of psychiatric disorders.
The effects of tACS are temporary, and they disappear once the stimulation is turned off. While generally considered safe, some side effects such as headaches have been reported, although these may occur at similar rates in sham stimulation. Consumer devices for tACS are available for purchase, but medical tACS devices can only be used by doctors or researchers.
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Non-invasive brain stimulation therapies
Transcranial direct current stimulation (tDCS) is a type of NIBS that uses weak electrical currents applied to the head to stimulate the brain. During a treatment session, two small wet sponge electrodes are positioned on a person’s head using a rubber headband. The current passes from one electrode to the other, stimulating the brain. Some people experience a brief sensation of tingling, itching, or pins and needles on the scalp underneath the electrode, but this typically lasts less than a minute, and some people do not feel anything at all.
TDCS has been shown to improve brain functions such as regulating emotions and enhancing cognitive functions like attention, learning, problem-solving, and memory. It has been used to treat mood disorders, stress, depression, and fatigue. It has also been shown to improve performance and preserve energy levels.
NIBS programs typically involve sessions five days a week for three weeks, and therapy may include physical therapy, occupational therapy, and/or speech therapy, depending on the individual's needs. Standardized tests, including written questionnaires and performance measures, are administered throughout the program to track progress and compare function from the beginning to the end of the program.
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Vagus nerve stimulation (VNS)
VNS has been approved by the U.S. Food and Drug Administration (FDA) as an add-on therapy for focal (partial) seizures in adults and children four years of age and older when medications have not controlled their seizures. It is also approved for adults with long-term or recurrent major depression that has not responded to multiple antidepressant treatments. Additionally, VNS has been approved as an aid for stroke rehabilitation, specifically to improve arm and hand function.
The device is implanted under the skin in the left chest area, with an electrode or wire attached to the generator device and placed under the skin, wound around the vagus nerve in the neck. The device delivers pulses or stimulation at regular intervals, and the amount of stimulation can be adjusted as needed. For example, if a person is aware of when a seizure is happening, they can swipe a magnet over the generator to send an extra burst of stimulation to the brain, which may help stop the seizure.
While VNS has shown promising results, it is not suitable for everyone. People with significant asthma, breathing problems, sleep apnea, or certain heart problems may be advised against using VNS as it could worsen these conditions. Additionally, individuals with only one vagus nerve or certain medical conditions, such as insulin-dependent diabetes mellitus, are not recommended for VNS treatment.
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Frequently asked questions
Transcranial Direct Current Stimulation (tDCS) is a method of brain stimulation that involves attaching electrodes to the head and transmitting low-voltage doses of electricity to stimulate the brain.
The brain functions by sending and receiving tiny electrical signals between nerve cells. tDCS stimulates specific regions of the brain with low levels of electricity to improve focus, memory, mood, and even dementia.
tDCS has been shown to reduce fatigue and improve or preserve performance. It has also been shown to improve symptoms of depression and ADHD.
Yes, there are some risks associated with tDCS. The treatment may cause itching, irritation, or small burns at the sites of the electrodes. Some users may also experience fatigue or headaches. The long-term effects of tDCS are still unknown.
