Apex Type A tDCS Device Review

Introduction

I am so pleased that an assortment of excellent tDCS* devices is now reaching the market – making the benefits of tDCS available to more and more people worldwide.  The range of devices is impressive – from simple and cheap to expensive and very sophisticated.

I won’t take the time or space here to detail all the potential benefits of tDCS or why you should consider obtaining a device – but suffice it to say that millions of people could dramatically improve their lives with tDCS. tDCS can be used to treat depression, chronic pain, enhance memory, and much more.  See the web sites I list below as a good starting point for more information on tDCS.

IMG_1980
(Apex Type A Main Unit)

The Apex Type A

The Apex type A “Adjustable Direct Current Generator” is a low priced but well-built device that uses a classic tDCS design that includes a 9 volt battery, an LM334 current regulator, a programming resistor to limit delivered current to about 2 mA and a meter to monitor current delivered.  This design (and variations) have been used by do-it-yourselfers for years (I’ve built several myself) and has proven to be very reliable, simple, and safe.

Apex saves you the considerable time and trouble to locate all the parts to build your own device by manufacturing a solid unit that looks like it will last for many years. The base unit alone sells for about $99 and a complete kit including head-band, electrodes, wires, etc. is about $139 (plus shipping).

Apex kit
(Apex Type A and accessories – from the Apexdevice.net web site)

As with most other tDCS device manufacturers, Apex does not provide medical advice, information about which tDCS electrode placements will work for you, etc. They leave it up to you to do your homework by reading the considerable about of material available online (see example links below) to decide if tDCS is right for you and what treatment method will work best.

The Apex Type A comes with a well written user guide that takes the user step-by-step through installing a 9 volt battery, connecting wires and electrodes, and running a simple test to see that the unit is working as it should.  There are two controls and two indicators on the type A:

  • On-off switch: clearly marked
  • Current adjustment dial: clockwise rotation raises current, the opposite to reduce current
  • Indicator LED: glows blue when the unit is turned on
  • Meter: I consider this almost a must-have in a consumer tDCS device. It clearly shows the amount of current being delivered during a tDCS session.

It’s also worth noting that the Apex Type A allows for the simultaneous connection of two sets of electrodes. Most users would rarely if ever do this – and it’s important to remember that device output current (max 2 mA) will divide between the sets of electrodes (probably not evenly – due to different resistance through the head at different locations.)

Testing and Use

As I mentioned above, I’m very familiar with the classic design of the Apex Type A and can say that the device performed exactly as expected – delivering a clean, DC current at a maximum of 2 mA (depending on dial setting.)

Construction

As you can see from the photos of the inside of the unit, build quality is very high.  All solder joints are well-made and clean, and mechanical attachment of the circuit board, controls, etc. is very solid. Some may object to the use of hand-assembly / perf-board instead of machine assembly / printed circuit board – and I might too except that the electronics of this classic design are very simple and as you can see involve only six solder joints on the circuit board itself.  As long as Apex continues good quality control and inspection procedures, this method of construction is perfectly fine.

IMG_1989
(Construction is simple and solid.)

IMG_1985
(Assembly is neat and well done.

Is 9 Volts Enough?

As far as a tDCS device is concerned, a human head is nothing but a big, liquid filled resistor. All the device does is try its best to deliver a consistent, stable one to two milliamps to cause the desired treatment effect.  9 volts is about the minimum that can reliably deliver the desired current level given circuit, hair, skin, etc. resistance that does it’s best to limit current flow.  Many commercial tDCS devices use 12 or 18 volts – some go as high as 80 volts! The higher voltages make it easier to overcome higher resistance (for example if one electrode is on the forehead and one on the shoulder). But the higher the voltage, the more opportunity there is for a painful (if not dangerous) experience if something goes wrong.  So many of the simpler tDCS devices elect to use a single 9 volt battery (or sometimes two in series).

Given the low voltage of the Apex Type A, it is very important that you do at least the following to make sure your treatment current is as you select:

  1. Use saline water and sponge electrodes (you can make your own saline and sponge electrodes if you like)
  2. Get the sponges really wet, then squeeze them out a bit (you don’t want water dripping down your head)
  3. Use a good head-band. Your head-band will need to be tight – not uncomfortably so, but tight

IMG_1991
(Controls are simple and work well. This is a Type A set for maximum current, with a new battery and shorted anode and cathode leads. Note the maximum current of about 2 mA.)

When you start a tDCS session, expect current to rise slowly (over two or three minutes) as your scalp or skin gets wetter. You may find it desirable to adjust the current control on the Apex Type A once or twice during your tDCS session.

Finally

Apex does a nice job of providing a simple, reliable, well-built tDCS device that will do exactly what it is supposed to do – provide clean 1 to 2 mA DC for your tDCS application. They provide good operation instructions with the device and have a wide array of backup material on their web site. Well done Apex!

Links

www.apexdevice.net

www.speakwisdom.com

www.diytdcs.com

www.reddit.com/r/tdcs

*tDCS is transcranial direct current stimulation

Time to Take Another Look At foc.us tDCS and more

History

About two years ago foc.us burst on the do-it-yourself tDCS scene with a headset marketed to “gamers” – claiming to offer improved game performance (higher scores).  A few folks like myself recognized the foc.us headset (V1) for what it was – a remarkable, capable tDCS device that could be used for ANY tDCS related purpose including treating depression, chronic pain, enhancing memory, etc. – and yes, improving game scores!  The V1 headset was truly a leap beyond anything else available to the DIY community offering an all-in-one headset that could be controlled via Bluetooth, offered built-on and external electrodes, all in a very nicely designed package.

focus-gaming-tdcs-headset-7
(Famous or infamous foc.us V1 ad campaign)

Critics quickly emerged, as they often do, describing customer relations related problems with foc.us – many justified, and technical issues with the product – many unjustified.  It seemed foc.us was surprised by their own success and unprepared for the order volume and normal support requirements of such a leading edge product. By the time foc.us got its organizational problems resolved, the V1 was winding down and the company was preparing to launch the V2.

The foc.us V2

Several months ago, Transcranial Ltd. launched it’s new foc.us tDCS product, the V2. It, like the V1, sets a  high bar for the DIY tDCS market. In a tiny package easily small enough to misplace with your car-keys, foc.us engineers included all of the technical features of the V1, plus the added versatility of upgradeable firmware (new features), display screen with scrollable selection, redesigned and industry leading headsets, the ability to use 3rd party headsets and related accessories, and more!

IMG_1530
(The foc.us V2. Tiny! Awesome!)

Interestingly, foc.us via their advertising, now seems to recognize the value of their technology for what it is, a real cranial stimulation device – not just for gamers – but for anyone seeking the benefits of tDCS and more.

images
(
The V2 ad campaign is more general – making clearer the broad capabilities of the V2.)

Since my initial posting about the V2 (see http://bit.ly/1Jilfpg ) Transcranial Ltd. has upgraded the feature set of the V2 in significant ways!  The V2 now supports tDCS, tACS, tPCS, and tRNS as well an upgraded application for Android devices and soon iOS. The V2 can no longer be referred to as just a tDCS device – it’s now a fully capable, research grade, cranial stimulation device!

It’s a Software World Now!

If you purchase a V2 (or own one now), you may wish to update its firmware periodically to take advantage of new features.  Here are some key steps:

  1. Go to the foc.us web site and create an account: https://www.foc.us/customer/account/login/
  2. Log in with the account
  3. Connect your V2 doc to your capable PC (or Mac)
  4. On the left of your screen (once logged in), select “My Downloadable Products”
  5. Click the “Microsoft Software” (or Mac) download button and install
  6. Run the installed application and allow it to check and upgrade your V2 to the latest firmware

Apps

An Android app is available (search for wave tdcs in the store.) An iOS app for the V2 is due anytime (the old V1 app does not seem to work with the current V2 firmware.) I will say that the on-screen display of the foc.us V2 is so good and so versatile that I’m not convinced that the apps currently add much value. Transcranial Ltd. is soon to release a EEG capability called “Quantum” that will apparently link to the V2 – and will probably make the apps very functional and important to use.

unnamed
(foc.us Android app)

Anyway, you must pair the foc.us device to your Android or iOS device to use an app. Here are normal pairing procedures:

  1. Make sure Bluetooth is turned on on your Android or iOS device
  2. Turn on the foc.us V2 and scroll to Settings, Bluetooth, and make sure Bluetooth is On.
  3. Very quickly your handheld device should find the foc.us device and request you type in a code number that you will find displayed on the foc.us device. Do that and you are ready to go!
  4. Run the foc.us app, set the desired mode (tDCS, etc.), max voltage (20 is typically fine), current (1 to 2 mA), time (typically 20-25 minutes), sham should be off, and START

I’ve noticed that the Android app does not display remaining session time.  You can see it easily on the foc.us device by tapping the blue joystick.

More Detailed Instructions?

Like most tDCS vendors, Transcranial Ltd. is trying to stay off of the FDA’s radar by making it clear that they are not producing a medical device – so they shy away from writing application guides and notes. This frustrates some. Users are left to their own creativity to learn how to properly use and get full advantage from a foc.us device (V1 or V2). To help V1 headset users, I wrote a pretty detailed set of instructions ( see http://bit.ly/1FSf6wb ) that seem to be popular.  Would you like an equally detailed set of instructions for the V2? Let me know – if there is sufficient interest I’ll be happy to put that together.

Finally, I’ve taken a good bit of heat via email and blogs for being a fan of foc.us. Unlike some, I saw very early on that their unique product(s), if used correctly, could be used to improve the lives of many – and that has turned out to be true. Foc.us continues to be one of my favorites in the world of tDCS and cranial stimulation and I, for one, anxiously await their next DIY leading-edge products and the pace they set for the industry.

I look forward to your comments and questions.

Brent

brent@speakwisdom.com

Notes:
1. Photos in this blog are from the internet and include images from foc.us and speakwisdom
2. If you are new to tDCS, please read and study carefully before taking any action related to tDCS or any cranial stimulation technology.  I suggest as a starting point:
a. speakwisdom.wordpress.com/tdcs/
b. diytdcs.com
c. www.reddit.com/r/tdcs
d. http://www.pubmed.gov (search for tDCS)

Summer is Here! Time for The Brain Stimulator Travel Model!

Travel Model Advanced 2x2 Kit - Unplugged_NEW
(The Brain Stimulator Travel Model shown with available electrodes, wires, and headband. The tDCS module itself is very small and easy to transport.)

I am a longtime fan and proponent of tDCS.  There is plenty of evidence that this simple, safe, technology can be used to reduce or eliminate depression, treat chronic pain (including migraine headaches), enhance memory and learning, and more!  If you are new to tDCS, take a look at the index of tDCS articles I’ve posted at https://speakwisdom.wordpress.com/tdcs/

If you are looking for a high quality tDCS device that also happens to be ideal for summer travel, you should consider “The Brain Stimulator Travel Model”.  This is a well-built, basic, tDCS device that can deliver 1 or 2 mA with the flick of a switch and can stand-up to being repeatedly tossed into a suit-case or travel bag, jostled around, and still come out ready to go and deliver a reliable tDCS session.  Depending on the configuration you buy, it can cost as little as $55 – or a bit more with high quality electrodes and other accessories.

The Brain Stimulator Travel Model also makes an excellent first tDCS device or a supplemental device if you already own something more sophisticated.  It is built by JD Leadam and his team at Neurolectrics – real pioneers in the DIY tDCS marketplace.

 

IMG_1692
(The packaging of the devices is simple, neat, and able to withstand travel related abuse.)

Neurolectics used a tried and true design built around a current regulator and a 9 volt battery. It’s simple, safe, and reliable – but because a 9 volt battery is used as its energy source, it is very important that sponge-electrodes be used and that they be well wetted with a saline solution in order to assure delivery of 1 or 2 mA (depending on switch setting).

I always prefer that a DIY tDCS device have some monitoring capability (digital or analog meter) to assure that the desired current level is being delivered. Neurolectrics chose not to take that path with this device – I assume to keep cost at a minimum and the package as small as possible.  If you are a frequent tDCS user, I’d suggest changing the 9 volt battery every couple of months – and again – be sure to use well wetted sponge electrodes to help assure you receive the selected stimulation level.

IMG_1690
(Neurolectrics places all significant components on a nicely manufactured PC board. This limits point-to-point wiring and makes for a more reliable device – important for a travel device.)

The Brain Stimulator Travel Model could not be easier to use!  Simply wet the electrode sponges, place the electrodes as desired with a headband, flip the switch to 1 or 2 mA, and begin timing your tDCS session (20 to 25 minutes is typical.) When done, switch off the device, take off and stow the electrodes and you are done.  If you really are traveling with the device, I suggest you remove the sponges from the electrode shells and place them in a small water-tight container.  You should also wash them frequently with good soap and plenty of water to prevent anything undesirable from growing in them!

I’ve taken several trips (including through airports and airport security) with the The Brain Stimulator Travel Model and found it to be quite handy for personal use and for demonstrating tDCS as seminars.  Don’t expect any flashing lights or fancy meter with this unit.  It’s basic tDCS – and it works.

Visit the Neurolectics website at https://thebrainstimulator.net/

I welcome your comments and questions.

Brent

 

 

Interview: JD Leadam, Neurolectrics

Here’s a chance to meet the founder and CEO of Neurolectrics – the creator of the BrainStimulator and the BrainStimulator Travel Model.  JD is a true pioneer in the DIY tDCS field and I hope you will find this podcast to be interesting and informative.

Click HERE to listen or download the mp3.  Total length is about 27 minutes, 12.5 MB

JD’s web site is HERE

Enjoy!

Travel Model Advanced 2x2 Kit - Unplugged_NEW

Using the foc.us V2 with the Gamer or Your Own Electrodes

Introduction

In part 1 of my series on the new foc.us V2 tDCS device, I introduced the basic components of the V2 as well as its user interface. I continue to be pleased with the V2 as a user and want to pass along some ideas related to electrode use.

The foc.us Gamer Headset

Foc.us offers two headsets for the V2, the Edge and the Gamer. The EDGE is a special purpose headset designed to facilitate experimentation and research on the use of tDCS to improve athletic ability. As I mentioned in the last post, this is an area of tDCS that is ripe for exploration. A few studies have already been posted that hint at possible uses for tDCS and improvements in physical ability. This will be a very interesting application of tDCS to watch as results from various tests are posted. The EDGE headset is not a general-purpose tDCS headset and should NOT be selected by most users.

The GAMER headset is a more versatile headset for the new or experienced tDCS user. It is made up of a flexible metal band and two electrodes that attach to the band. It is highly adjustable for head-size and comfort. “Out of the box” it is designed to allow stimulation of the pre-frontal cortex, an area associated with memory, learning, etc. It happens that the electrodes of the GAMER can be used independent of the included band – allowing electrode positioning for “savant learning”, treatment of chronic pain, depression, etc. Note: the electrode plainly marked “Left” on the inside of the sponge frame is the anode (+) and the electrode marked “Right” is the cathode (-).

IMG_1574
(The Gamer headset.  Best choice for most.)

IMG_1560
(The Gamer headset in its case.)

 

IMG_1564
(The Gamer on my “test head”. Note electrodes are positions over the pre-frontal area.)

IMG_1570
(You can use the Gamer electrodes without the supplied metal band and place them where you want. Here I’ve used an elastic band to position the electrodes for “savant learning”.)

IMG_1573
(Here is another example with the electrodes positioned to treat chronic pain. In this example, the cathode would be placed on the upper arm or shoulder with another band.)

UPDATE – March 2015

foc.us has updated the firmware on the V2 so that the resistor that tells the tDCS module which headset is connected is no longer needed.  FURTHER – they are also released a patch cable to make attaching 3rd party electrodes even easier. See (  http://www.foc.us/tdcs-tens-cable-adaptor ).  The text below is left for historical reference only.

Using Your Own Electrodes (Amrex)

If you are pretty good with a soldering iron you can easily adapt any electrodes you prefer for use with the foc.us V2. The jack on the V2 tDCS device is a four conductor, 2.5 mm type that has been used on some cell-phones and portable audio gear. Connect your electrodes to a four conductor, 2.5 mm plug and a small resistor and away you go!

Plug Wiring

Tip and Ring 1 – a resistor across these two tells the tDCS device the model of headset connected. (300 ohms for the Edge, and 2,000 ohms for the Gamer by my measurements)
Ring 2 – Cathode connection (-)
Ring 3 – Anode connection (+)

To test this, I used a small RadioShack proto-board and broke out the 4 conductors for easy investigation and tinkering. I used a 100 and 200 ohm resistor in series to get the 300 ohms needed to let the V2 “think” I am connecting an Edge headset, even though I use popular Amrex 3x3s. Actually it seems not to matter whether the V2 thinks an Edge or Gamer is connected – you can still set all the desired tDCS treatment times and current levels.

IMG_1549
(Note the four conductor plug. It is broken out on the proto-board with T, 1, 2, 3 as described above. I use this example with Amrex 3×3 electrodes.)

Perhaps in future firmware, foc.us will include special features for 3rd party headsets that use a different resistance identifier.
BTW Soldering wires to a four conductor, 2.5 mm plug is not for the faint of heart. It’s very easy to short contacts and generally make a mess. I suggest buying a pre-wired 2.5 mm plug from Parts Express (or similar). Their part number is 090-504.

Summary

So there you have it. I suggest that you either buy the foc.us GAMER headset with your V2 and use it as is or with your own headband as I have shown above – or do your own thing with a 4 conductor plug and whatever electrodes you prefer.

Please feel free to send along comments and suggestions related to this post or a future one you would like to see.

The NEW foc.us V2 tDCS Device and Headsets, Part 1

IMG_1530
(The tiny V2 module is now the core of the foc.us tDCS product line.)

Introduction

Once again, foc.us has distanced itself from the rest of the tDCS device pack. If you are in the market for an innovative tDCS device that is sophisticated and simple to use, I think you will be very pleased with the foc.us V2. tDCS is all about delivering a tiny current to the brain in order to improve it or provide relief from a brain-related condition. Here is a way to do it with a cool device that works well!

Enter foc.us

The first foc.us headset moved the bar on tDCS devices by offering a huge feature set (built-on or external electrodes, wearable, Bluetooth support, iOS app, etc.), and a moderate price. I don’t have any sales data on the foc.us V1 headset, but I’ll guess foc.us sold more than a few.  I happen to own more than one and use them often. I’ve also helped many others achieve tDCS success with the foc.us v1.

IMG_4664
(The foc.us V1. Slick. Innovative.)

As a radically new design from a brand-new start-up, the foc.us V1 was not without its problems or detractors. There were production problems, support problems, unpolished features and more – that for some made it hard to see the real core value of the headset as a tDCS treatment device. But given how far foc.us pushed the DIY tDCS market, those of us who really learned how to use the headset were (and are) thrilled to have it.

The foc.us V2

foc.us did not stand still though. Based on experience with the v1, user input, and their own vision of what tDCS could become, the foc.us v2 tDCS device and accessories have been created and are now moving toward distribution.  The new device has three basic parts of which the buyer can purchase as desired.

  1. foc.us V2 tDCS Device – REQUIRED (does the work of producing the tiny DC current used in tDCS.)
  2. Gamer Headset (plugs into the V2 device. Electrodes positioned for stimulating certain types of learning)
  3. EDGE Headset (Plugs into the V2 device. Electrodes positioned to possibly enhance athletic performance.)

The V2 tDCS device itself is now a tiny module not much bigger than some USB flash-keys.  It is programmable, has a graphical display, a joy-stick like control for selection of desired tDCS parameters, and is rechargeable and updateable (firmware) via a USB base.

IMG_1512
(As expected from foc.us, innovative design and nice packaging.)

The Gamer headset is a flexible band with two electrodes designed to reach the pre-frontal cortex area of the brain – an area thought to respond nicely to tDCS for improvement in some types of thinking and learning (concentration, planning, judgment, etc.)

IMG_1564
(The new foc.us Gamer headset. Bigger sponges, very comfortable. Shown on my “test head”. There are better photos at www.foc.us)

The EDGE headset represents new ground for a commercial tDCS device.  Many of us have wondered how long it would take the world of athletics to discover tDCS and the potential it holds for improving performance in many competitive and non-competitive sports.  To that end, foc.us offers the EDGE headset designed to place the anode in the area of the premotor cortex (coordinates complex movements) and the cathode on the upper arm.  Much research and experimentation in this realm of tDCS is needed, but suffice it to say that one day the top performers on your favorite sports team may be using tDCS during at least some of their training.

IMG_1556
(foc.us calls attention to the possibilities for athletic improvements via tDCS and the EDGE headset. Shown on my test head. Foc.us headset sponge-sockets are now nickel plated – instead of copper as in the v1. Better images are at www.foc.us)

Operation

I was fortunate enough to have received a foc.us V2 at the beginning of December, 2014, with an early firmware and feature set. Suffice it to say that, even in its early form, it performs well and is very easy to use.

Using the V2 is simple: Unpack the V2 tDCS device and place it on the USB charger for an hour or two to fully charge. Meanwhile, remove two sponges from the sealed envelope supplied with your foc.us headset, wet them a bit (saline if you prefer), and place them in the sponge sockets (or use your own electrodes and headband as described in the next blog post.)

With the headset in place and plugged into the V2 device, press the blue joystick on the v2 tDCS device to activate it.  Then simply step through the prompts to setup your tDCS session parameters.

IMG_1545
(The display is easy to read. Duration and current are easily changed.)

Your tDCS session will begin with a short ramp-up time and then a count-down of the session time remaining. Actual current delivered is displayed and graphed.  You can press on the joystick at any time to immediately end a session.

IMG_1544
(Prompts are simple and clear.)

For you techie folks: Note that the foc.us V2 does contain a boost circuit to overcome electrode and skin resistance – as do many commercial tDCS devices.  I measured a peak of 56 volts as the V2 tried to compensate for my high-impedance load test and deliver the selected current level.  At no time was I ever able to exceed the current level I had programmed on the V2 device.

A Few of the Many Enhancements Over the foc.us V1

  1. Very small, portable, tDCS device. You could easily Velcro it into your cap or just put it in your pocket. It is easily programmed for desired tDCS settings.
  2. foc.us electrode sponges are much larger (and better quality) than with the v1 for better current distribution
  3. More comfortable headsets
  4. Can be used with foc.us, 3rd party, or user provided headsets and electrodes

Concerns

  1. Three or four tDCS sessions seems sufficient to drain the battery in the early production device. I think it will be a good habit to put the V2 device on its charger when not in use.
  2. There were complaints that foc.us seemed overwhelmed when the v1 was released about two years ago – leading to spotty technical support and order-issue resolution problems. Has foc.us learned from the V1 experience?
  3. The V1 IOS app never seemed to reach a solid feature completion. It works – but… Will the V2 app be better? foc.us says it will.  They have a new programming team and will release a new app for the V1 and V2 in the January/February timeframe.  But to be clear, you DO NOT need an app to use the V2 very effectively.

Overall Impressions

I’m very pleased with my early copy of the V2.  It works well, is tiny, easy to use, and produces clean, predictable output.  The new foc.us headsets are innovative and comfortable. The V2 represents a nice step forward for foc.us and for the DIY tDCS community. I look forward to continued development of the V2, firmware, apps, and 3rd party add-ons that are likely to come.

Pricing

Pricing is about the same as with the V1 (it was about $250 plus $50 for a needed accessory kit.) The V2 is $199 for the tDCS module. foc.us supplied headsets are priced at $99.  A pack of 12 foc.us sponges is $5. You are free to use 3rd party or your own electrodes if you prefer (details in my next post.) See www.foc.us for ordering details.

Bottom Line

The foc.us V2 is clearly more sophisticated and better designed than the typical tDCS device in the market right now.  Yes, it costs more than entry-level devices – but as the saying goes, “you get what you pay for”.  If you are serious about tDCS for yourself or someone you know, the foc.us V2 deserves your consideration.

Brent Williams, PhD
http://www.speakwisdom.com

Coming at www.speakwisdom.com

Over the next weeks and months, I’ll post a number of articles about the foc.us V2, use, applications, and more.  Feel free to contact me with your questions and comments via brent@speakwisdom.com

IMG_1549
(My crude but effective breakout of the new V2 four conductor plug. Yes, you can use Amrex and other electrodes.)

Why I Love tDCS and the New tDCS Device from SSD

Introduction: Why I Love tDCS

I’ve been involved with transcranial direct current stimulation (tDCS) research and application for almost three years now.  When I stumbled upon it, I could not believe (like most of you) that something so simple could do so much good. A 9-volt battery curing depression, relieving chronic pain, improving memory, speeding learning, and much more – really?!  It turns out to be true.

IMG_1505
(The new SSD tDCS Device. see below)

I’ve provided information on tDCS to dozens of people (thousands via my blog) with an array of needs and interests who have had great success helping themselves improve their lives through tDCS.  I could provide many examples, but here is one to illustrate my point:

A woman, (friend of the family), came to me describing deep, debilitating depression – to the point of becoming suicidal. Normally I would immediately refer such a person to Dr. James Fugedy, a tDCS practitioner in Atlanta – as I am a PhD, not MD.  But she had already failed on other kinds of treatments via other doctors, including medication, talk therapy, and was at the end of her rope. She was very, very depressed – but wanted to get better – she just had no idea how to go about it.

I talked to her about tDCS and the published information that shows improvement for some challenging depression cases. I showed her how to use a tDCS device and where studies have shown electrodes should be placed for treating depression – but left it up to her to treat herself or not.  She immediately started once-a-day 25 minute tDCS sessions (1.5 mA). Within five days her mood had lifted greatly and I think she had moved out of the suicide danger zone. She continued daily tDCS treatments for the next four weeks. As she did so, her depression fully lifted. She recovered so well that she felt motivated to enroll in a technical school to learn a new skill – and in her classes scored the highest on all tests (a side-effect of the tDCS?)

She now lives a normal, happy life (yes – with its ups and downs like anyone.)

Seeing people get their lives back in such a simple way, with no debilitating side-effects, has made me a cheerleader for tDCS.

Does it work for everyone? It won’t work for everyone – but what treatment (or pill) does? My observation is that tDCS works for those motivated and willing to consistently use it in the way research studies have shown it should be used. tDCS in combination with talk-therapy seems particularly well suited to treating depression – which in many has its roots in a brain dysfunction – not evil-spirits, selfishness, or a bad attitude as some suggest. By modifying the firing potential of the neurons in key portions of the brain it seems real healing can be achieved.

Review: New tDCS Device from SSD

Super Specific Devices has released a tDCS device that might be just right for that DIY tDCS person on your holiday shopping list (perhaps yourself!) The new tDCS device is a well-built variant of a DIY tDCS design that has floated around the internet for about two years now.

The Super Specific Devices (SSD) device offers solid performance, based on a 9 volt battery, and provides a feature I consider nearly essential – a meter that allows you to verify the current being delivered during your tDCS session.  That is coupled with a potentiometer (dial) that allows you to vary current level, making it easy to set 1, 1.5, or 2 mA or anywhere in between.  The user can also gently ramp current up and down using the dial – so discomfort and phosphenes are reduced or eliminated.

IMG_1508
(Jack on the side for standard TENS style electrode cables)

What Comes in the Box

The SSD tDCS device is fully assembled and comes with a starter set of stick-on electrodes, a couple of sponges, a connecting wire, basic instructions, and a headband. The unit does not come with a 9 volt battery or any sort of an application manual.  Like many of the US-based cottage-industry building tDCS devices, they leave it up to the purchaser to do their own research on the internet to decide what additional electrodes, electrode placements, etc. are appropriate to the purchaser’s situation.  The intent is probably to keep the company off of the FDA’s radar as the SSD (and similar devices) are not marketed as medical devices – nor does the company provide medical advice.

Features

To use the SSD tDCS device, one needs to insert a 9 volt battery into the socket on the side of the unit, plug in and apply electrodes, and then use the power on-off switch and dial to operate the unit.  To start a session, the dial should be rotated fully counter-clockwise (minimum current) and then switched on. An LED indicator just above the on-off switch will light to show that power is on.  Assuming electrodes are in place, the user then begins rotating the dial clockwise, watching the meter for rising current level.  Note that due to skin resistance, there is a lag between dialing in a higher current level and that level actually being achieved.  It can take a couple minutes or more for current to rise to a set level and stop. An alternative is to turn the dial significantly clockwise and turn it back down as your desired current level is achieved.

On my sample unit, even with electrodes shorted and the dial set fully clockwise, the unit would not deliver more than about 2.7 mA. On the inside is an LM 334 current regulator and a series-connected current limiting diode that limits output current to 2.7 mA – as I found in my testing (good safety feature). This is a nice, simple, practical, current control setup that should prove reliable for many, many years.

IMG_1501
(Good build quality. LM 334, CRD and resistors on small circuit board, solder joints were solid, wires nicely dressed.)

Another nice feature of the SSD tDCS device is having a jack on the side of the unit for electrode wire attachment – it’s the standard TENS size that lets you use a variety of connecting wires supplied by Amazon, medical supply houses, etc.

IMG_1507
(Electrode wire jack and current adjustment knob can be seen here.)

What Would I Change?

I’ve built several tDCS devices using the same basic design of the SSD tDCS unit.  So I’m very familiar with use, operation, and limitations of this type of device – and I’m allowed to nit-pick.

First, let’s be clear – it’s my opinion that this unit will operate as described by the company and will provide clean, regulated DC current for most common tDCS scenarios.

I happen to prefer using a type 23a 12 volt battery in my tDCS device designs.  Why? 9 volts is sometimes insufficient to overcome losses in the electronics, electrodes, and skin to provide the desired 1, 1.5 or 2 mA used in tDCS sessions.  In fact, 9 volts will probably not be sufficient if one of the electrodes is located on the shoulder or arm for a montage you wish to use. Sometimes a 12 volt battery will barely do it – but the additional 3 volts really seems to help. The downside of the type 23a battery is they don’t last long (2 or 3 months is normal with a lot of use.) But they, like 9 volt batteries (which last much longer in a tDCS device) are cheap (Amazon, Ebay.) I’m betting SSD went for long battery life (and easy availability of cheap batteries) in their design criteria.

IMG_1506
( 9 v battery socket on the side. Aesthetically, it would be nicer to locate it inside the roomy box.)

By the way, many “commercial grade” tDCS devices use a voltage boost circuit that can raise delivered voltage to between 60 and 80 volts – as needed – to overcome skin and electrode resistance (like foc.us, Activa Dose II, and others). These boost circuits sometimes add discomfort for the user, increase device cost significantly, and so are not present in lower price tDCS devices like the one from SSD.

Summary

If you are looking for a well-built, inexpensive, tDCS device that includes a lot of good features (meter, adjustability, good current regulation and protection, and more) then this might just be the unit for you (or someone you know.)  You’ll need to do your own research on tDCS, its appropriateness for your situation, tDCS safety, and the electrode placements that address your need.  See any of the following as a starting point:

www.speakwisdom.com

www.diytdcs.com

www.transcranialbrainstimulation.com

www.pubmed.gov (search for tdcs)

…and Google search tDCS

The Super Specific Devices tDCS device sells for $90 at http://www.superspecificdevices.com/ Oddly it sells for a bit more on ebay.com (go to ebay, search for tDCS). SSD also sells the same unit with a digital display for $20 more if you prefer (at their web site and ebay).

Based on my evaluation and use of a sample unit, it’s my opinion that the SSD tDCS device (design, build, and features) is a good value.

How the WHO Could REALLY Reduce the Global Suicide Rate 

Introduction

In September, 2014, the World Health Organization (part of the UN) released a report indicating that over 800,000 people, world-wide, commit suicide every year.  That means about one person every 40 seconds, 24 hours a day, 365 days per year, tragically ends their life.  Reasons and methods vary greatly, of course, but certainly the most significant contributor to the suicide rate is the epidemic of depression. In the United States, about 40,000 people commit suicide every year – again most as a result of depression.

By the way, gathering suicide data is difficult because many suicides go unreported or countries simply don’t collect suicide data – or don’t do it effectively. So if anything, the 800,000 number is, perhaps, a dramatic understatement.

In the same report, WHO indicates they are “committed” to reducing the global suicide rate by a whopping 10% by 2020.  How they plan to accomplish even this anemic goal given the status-quo of diagnosis and methods of treatment is a mystery. Without an aggressive approach, using new technologies that could be widely employed in developed and underdeveloped areas – the WHO goal is meaningless. Part of the problem is that the current medications typically used to treat depression are expensive, not readily available in some locations, may need to be taken for a lifetime, and have side-effects (some serious) that can discourage use.

Enter tDCS

Transcranial Direct Current Stimulation is a simple technology that has been shown to reduce or eliminate depression in many individuals. Treatment involves using a tDCS device for about 30 minutes a day for 30 to 60 days with an occasional follow-up treatment as needed. It also happens that tDCS is safe and easy to administer.   A tDCS device is very simple to construct using readily available components – for perhaps $10 to $20 dollars – much less than the cost of a single month of anti-depressant pills.

For a relatively small investment by the WHO, millions of tDCS devices could be built and distributed world-wide. In day long sessions, doctors, counselors, and other professionals (including an army of volunteers) could be trained to identify, screen, and treat depressive persons. The training could even be conducted over Skype, Google Hangout, or similar means, eliminating the cost and complexity of travel in certain areas. Once trained, the important work of markedly reducing the world-wide suicide rate – by identifying persons in need, teaching them how to treat themselves, and following up as needed to assure positive progress – could begin.

A Simple World-Changer tDCS Device

Below are images of a simple tDCS device that could be cheaply constructed and made widely available to trained professionals and volunteers. I purposely built the device components into a pill-bottle to drive home the point that a tDCS device can be small, cheap to build, and replace expensive, side-effect laden pills for many depression sufferers.

IMG_1440
The major components of this tDCS device (above) include a 9-volt battery, two one milliamp current limiting diodes, a pill-bottle for a case, two electrodes to place on the head, and a headband. This design uses two CRDs in series to make the device nearly failure-proof. Should one CRD fail, the second continues to limit treatment current to one milliamp. The CRDs are at the bottom of the picture, shown just before covering them with heat-shrink tubing.

IMG_1465

The completed tDCS device is shown with my “test-head” (above), complete with electrodes and a head-band. The tDCS device was constructed in about 30 minutes. Total cost for the tDCS device and wires was about $5. The cost of electrodes varies from about $1 dollar up to $30 dollars depending on the type selected and the supplier. A mass-produced equivalent of this setup could be used prevent thousands of suicide deaths every year – each device, electrodes, and headband costing less than a months supply of anti-depressant pills. Are you paying attention WHO?

Helpful References

If you are new to tDCS, may I suggest you at least examine the below:

1. www.speakwisdom.com

2. www.diytdcs.com

3. www.transcranialbrainstimulation.com

4. www.pubmed.gov (search for tDCS)

Almost Criminal – tDCS Still an Unknown Depression Treatment

Introduction

This blog post deals with a very important topic: treating depression with tDCS. If you know anything at all about transcranial direct current stimulation (tDCS), you surely know that it has been shown in studies and anecdotal reports to have very positive effect on many depression patients – ranging from those with dysthymia to persons with severe, debilitating, drug resistant  depression.  It does not work for everyone, but what treatment does?

The beauty of tDCS is that it is incredibly simple, has a spotless safety record, has no significant side-effects, and with a little training can be used by a depression sufferer at home or wherever convenient.

Lets review some sobering facts: depression is a worldwide epidemic.  In the US alone, over 14 MILLION people suffer with some form of a major depressive disorder. About 1 in 10 adults now use some form of an antidepressant. Further, about 40,000 people per year commit suicide. (CDC)

What the numbers don’t tell you is that many suffering with depression don’t receive effective treatment – either because they don’t have access, can’t afford it, or commonly, are afraid of the public stigma of having to deal with a brain disorder. And lets be clear depression is a brain disorder.  For some, it can be treated effectively with “talk” therapy. But for many, depression is rooted in a brain physiology and chemistry problem and needs to be recognized and treated as such.

It really bothers me that mental health professionals are still mostly oblivious to the existence of tDCS and its potential benefits for the depressed. Every mental health professional should be aware of tDCS and use it when it seems appropriate – perhaps before or in conjunction with drug therapy.

Three Examples of tDCS Depression Treatment Montages

tDCS involves placing electrodes on the head and passing a very tiny direct current through them in order to achieve a desired effect.  Because the causes of depression are individualized, an electrode placement that works for one individual may not work for another. Current level may also need to be adjusted. It’s important that a depression patient being treated with tDCS be monitored to make sure progress is being made as treatments continue. If no improvement is detected after a few treatments, it may be time to try one of the other depression montages.

A normal depression treatment protocol is for 20 – 25 minutes of tDCS at 1, 1.5, or 2 mA at least 5 days per week for 30 days.  Treatment is sometimes continued for an additional 30 days for maximum result.  “Booster” treatments can be administered at anytime in the future as needed if depression symptoms begin to reappear. Some individuals are unable to tolerate 2 mA tDCS due to skin irritation.

Depression Montage #1

Image 1

The anode (+ lead) electrode is placed high on the left forehead while the cathode (- lead) electrode is placed on the right forehead. This is the most commonly used depression montage.

 

Depression Montage #2

image 2

The anode (+ lead) electrode is placed over the right temple while the cathode (- lead) electrode is placed over the left temple. This montage is interesting because not only can it alleviate depression, it is associated with improvements in intuitive thinking.

Depression Montage #3

image 3

image 4

The anode (+ lead) electrode is placed over the left forehead (supraorbital region) and the cathode ( – lead) is placed over the occipital region (middle of the back of the head, about even with the ears.) This is a recently published montage that showed very promising results in a small study.

 

Helpful References

If you are new to tDCS, may I suggest you at least examine the below:

1. www.speakwisdom.com

2. www.diytdcs.com

3. www.transcranialbrainstimulation.com

4. www.pubmed.gov (search for tDCS)

tDCS Devices

tDCS devices are entering the marketplace with increasing frequency. Here are some suggested consumer level devices to examine (in no particular order):

1. www.foc.us (buy with accessory kit)

2. www.tdcs-kit.com

3. thebrainstimulator.net

4. www.trans-cranial.com/tct/end-users-patients/tdcs-stimulator-products

5. www.cognitivekit.com

There are many more tDCS devices in the market, including impressive, expensive, professional models.

Conclusion

Its time for mental health professionals to get serious about helping their patients needing more than talk therapy with something other than a prescription drug. There is plenty of evidence and anecdote that tDCS can help many depression patients at the same level or better than medications – without all the side-effects and expense.  Do some research, attend a conference, speak to doctors now using tDCS and help end the epidemic of depression.