tDCS (Transcranial Direct Current Stimulation) 2024: How it Works, Benefits & Applications

Finding a definitive treatment for depression is a hot spot for major researchers all around the world. Psychotherapies, medications, and Complementary Alternative Medicine (CAM) have been used extensively. Recently, brain stimulation as a therapy for treating depression has been gaining momentum in the scientific community.

Brain stimulation in simple terms means awakening the brain with the help of electric currents.

But please wait!

We know you are thinking of an electric shock as you might have seen in the movies. Brain stimulation means using magnetic fields and electric electric to enhance the neural activity of the brain. There are multiple types- TMS, ETMS, tACS, TES, tDCS, etc. In the current existing therapies, tDCS therapy is emerging as an easy-to-use therapy for treating depression.

What is tDCS?

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation (NIBS) technology that uses electric current to enhance brain activity. It excites the neurons (brain cells) and increases the synaptic transmission of neurons.

Synaptic transmission means the messages that are passed through neurons. The basis of this technique is neuromodulation (altering the brain activity) through electric currents to treat various mental health disorders.

We know the words - brain stimulation, electric currents, and altering brain activity might sound scary.

But do not sweat, tDCS therapy is extremely safe. It has been used for many years and has a proven record of reducing the symptoms of mental health disorders. More than 10k clinical studies have been published, proving the efficacy of the procedure. The best part about using tDCS is that there are no adverse effects on short-term or long-term usage.

What does the transcranial Direct Current Stimulation (tDCS) device look like?

The tDCS device is a battery-powered tDCS brain stimulation device that supplies electric current. It consists of a control panel that helps to set the parameters for stimulation (duration and intensity of the current). It is attached to the wires which are further connected to two electrodes.

Electrodes are attached to the scalp for passing the current. The electrodes are damp with saline water to allow the current to flow. These electrodes are placed on the head with the help of a headgear. It helps to brace the electrodes on the scalp efficiently. The wires connect the electrode to a stimulator. When the stimulator is turned on, the current flows from the device to the head. The intensity of the current is modulated to make it bearable.

Since the time tDCS was invented, multiple modifications have been made to make the device simpler. Currently, a new modification of this technology has been adapted by Mave Health.

The ‘ARC’ has been constructed based on the tDCS technology. It is a modified version of the transcranial direct current stimulation that is being used to treat depression and other mental health disorders. The distinctive part of the ARC is its portability. Unlike the traditional wires and an electric box, the ARC is wireless and can be easily worn like a headgear. The parameters can be adjusted and the brain stimulation can be performed easily.

What is tDCS used for?

As mentioned earlier, tDCS is used for treating patients who suffer from Major Depressive Disorder (MDD). It is used extensively in motor rehabilitation for treating patients after a stroke. It has also been used to treat neuropsychiatric conditions brain injuries and pain management. It modulates the cortical excitability (change in the action potential of neurons) to enhance the activity of the brain.

To understand how tDCS helps with such conditions, let’s take the example of Aditya, a 26-year-old guy who is going through depression. He took the aid of therapy and his psychologist made him understand what depression is. He also understood the science behind depression. When in depression, brain activity is severely affected. The signals passed through the neurons are affected.

With the help of tDCS, these neurons are excited again. The signals are activated again and the brain activity is enhanced. Along with treating depression, tDCS also helps patients suffering from anxiety, PTSD, fibromyalgia, and spinal cord injuries. It has also been shown to reduce the symptoms of people having Parkinson’s disease, Alzheimer’s disease, and other neurodegenerative diseases.

What are the benefits of tDCS?

tDCS has an impeccable record of treating depression. It is flexible in terms of protocols and dosage. tDCS has also been known to enhance learning.

In a study conducted, the application of tDCS for stimulating the prefrontal cortex improved the motor memory of the subjects. tDCS is a great intervention in practices like working memory training.

This is possible because tDCS enables “Long-term potentiation” that enhances the neuronal plasticity in individuals. It helps to strengthen the transmission between the cells.

When it comes to brain stimulation, multiple methods are being applied to treat mental health disorders. However, tDCS is much safer than compared to TMS. It has been shown to have minor signs of adverse effects and can be used at home. As far as using tDCS goes, the only effects it shows are slight tingling and itching in the head. In rare cases, there are occurrences of headaches too. However, the effects are restricted to the site of stimulation and reside after the completion of stimulation.

How does tDCS work?

tDCS stimulates and activates the brain by sending electric signals. The electrodes used in tDCS are of two types: the anode and the cathode. One of the electrodes is placed on the area of the brain to be stimulated while the other is placed on the right or the left side of the scalp, right above the eyes. The electric current flows and directly reaches the neurons. It passes a weak electric current of 1-2mA continuously through the scalp.

Stimulation of the anode leads to the shift in the membrane potential (difference between electric charge inside and outside the neuron) causing a rapid rise in the potential (depolarization). This is how the neurons are activated and swiftly pass on the information. Once the anodal stimulation is completed, cathodal stimulation then repolarizes the neuron, thus bringing it to a normal state. The activation of neurons leads to the activation of parts of the brain that were targeted for treating depression.

What is the duration of tDCS?

Ideally, a neuro-stimulation session with the help of tDCS has to be used for 20- 30 minutes each day. The duration of each session should be altered only after seeking medical advice.

The number of times the stimulation is provided to a patient depends upon the medical professional’s advice. The duration can vary from 5 days to several weeks. In a study conducted by researchers, stimulation provided for a month resulted in a decrease in the symptoms of Major Depressive Disorder (MDD).

The duration differs according to the reason for requiring tDCS. For example, memory enhancement and learning might require shorter duration, while treating chronic pain, fibromyalgia, and mental health disorders require longer durations.

Where should I target stimulation?

The target site of stimulation varies according to the area affected. For example, in the cases of mental health disorders like depression or anxiety, the prefrontal cortex is targeted for stimulation. The prefrontal cortex (PFC) is a significant nerve center of thinking and behavior regulation in the brain. For linguistic problems, the posterior area of the brain is targeted for stimulation.

The dorsolateral prefrontal cortex (DLPFC) is targeted extensively to induce neural plasticity (adaption of structural and functional changes in the brain).

Where should the reference electrode be placed?

The positioning of the reference electrode depends upon the position of the target area. One of the electrodes - the anode, is placed on the target area while the reference electrode (cathode) is placed on the opposite side of the target area.

There is a possibility of the target area being small. To achieve success during the stimulation, brain imaging using fMRI or PET should be done.

What stimulation intensity should be used, and for how long?

A recent study published in The Journal of Neurophysiology suggests that a stimulation intensity of 0.7 to 2mA of electric current is ideal for optimum results in tDCS.

A study also revealed that tDCS sessions with 4mA of current although stimulation at this intensity had an increase in burning and itching while some had headaches. It is advisable to consult a professional before starting with the tDCS treatment.

What is the success rate of tDCS?

tDCS is gaining popularity because of its efficacy rates. It has been proven to prevent relapse of major depressive disorder and treat bipolar disorder effectively in patients who were not taking any medications.

It has been shown to improve the cognition of patients suffering from Alzheimer’s disease. It is now being used extensively to slow down the progression of the disease. 40-60% of the patients suffering from chronic pain had relief in their symptoms.

With Mave Health’s ARC-tDCS, patients have shown great success in solving their mental health-related concerns. 88% of them showed improvement in their depression score, 65% mood and cognitive improvement and 72% have achieved remission from depression.

Applications of tDCS in 8 ways

1.Cognitive enhancement

Several reviews have reported the use of tDCS for cognitive enhancement in individuals. Stimulating the dorsolateral prefrontal cortex has been shown to enhance working memory, attention, and skill acquisition of individuals.

2.Depression

tDCS has a deep impact on the transmission of the signals in the brain. Since depression affects this transmission, tDCS is used to stimulate the neurons and establish stronger connections. It leads to neuroplastic changes in the brain. tDCS facilitates the uptake of serotonin, which is an important ‘feel good’ chemical for the brain. It is important in regulating the mood and focus.

3.Anxiety

Anxiety is one of the most prevalent and debilitating psychiatric conditions worldwide. Research has shown that an imbalance between the right and the left prefrontal cortex is the epicenter of negative emotions and anxiety.

tDCS has been used for treating anxiety disorders like social anxiety disorders, generalized anxiety disorder (GAD), major depressive disorder (MDD), etc. A patient with progressive GAD underwent tDCS for a month. After a month of stimulation, the patient was asymptomatic. When patients with severe burns were given tDCS, the mean pain anxiety score of 17.2% people was reduced. This proves the efficacy of tDCS as an effective treatment for anxiety.

4.Chronic pain

The most attractive trait of tDCS in pain management is the establishment of neural circuits that can curb pain after a few sessions of stimulation. It alters the pain processing networks and reduces the intensity of the pain.

tDCS interacts with various neurotransmitters in the brain, such as dopamine, acetylcholine, serotonin, and g-aminobutyric acid (GABA). All of these help to alleviate the intensity of the pain. Multiple studies have been carried out proving the usefulness of tDCS to manage the chronic pain of people suffering from Multiple sclerosis, fibromyalgia, pain due to spinal cord injury, etc.

5.Stroke rehabilitation

Post-stroke consequences can be a great burden to the victim and its family. Stroke majorly causes loss of sensations, motor functions, and cognitive impairment. Daily sessions of tDCS have been shown to improve upper limb function in stroke patients, as well as increase scores on activities of daily living (ADLs). It increases the calcium currents and activates neurotrophic factors that are important for strong neural connections.

These findings have been confirmed by meta-analysis where various researches of tDCS prove that it improves motor function in mild to moderate stroke patients.

6.Addiction

Craving is associated strongly with relapse. By applying tDCS to addiction patients, the connectivity in the brain regions is altered. A research conducted in Taiwan showed that tDCS effectively reduced cravings for opioids, methamphetamine, cocaine, and tobacco but not for alcohol or cannabis. Long-term application of tDCS is yet to be done but can be a potential therapy to bring addiction cravings to a minimum.

7.Alzheimer's disease

Alzheimer’s disease is one of the most common neurodegenerative diseases in the world. An estimated 6.9 million above the age of 60 have Alzheimer’s disease. tDCS is now perceived as an emerging tool to treat Alzheimer’s disease. It is used for managing the symptoms of Alzheimer’s by improving cognitive functions and enhancing the memory of the patients.

8.Other potential applications (e.g., sports performance, education)

tDCS has a great approach to improving athletic performance. The use of tDCS significantly improves the performance of an individual and maintains the heart rate of the individual during the activity. The stimulation provided to the right inferior prefrontal cortex improved the threat detection efficacy of the sportsmen and the sensorimotor cortex effectively reduced fatigue.

In educational settings, tDCS promotes learning in both adults and children. tDCS is combined with cognitive and memory-based tasks to see the amplified effects. Recent studies have shown results like enhanced concealed image detection, enhanced skill learning in spatial and verbal working memories, language acquisition, and motor skills development with training while tDCS was being used.

What are the Side effects, Risks, and challenges of tDCS?

tDCS is considered to be highly safe when compared to other brain stimulation techniques.

tDCS has been examined as a potential therapeutic intervention in multiple clinical disorders, including depression, chronic pain, stroke, Alzheimer’s, and Parkinson’s disease.

Side Effects:

While its efficacy rates show great potential, there are certain side effects a person might experience while using tDCS. The user might experience skin redness, irritation, and itching on the site of stimulation. Individuals with low tolerability to the stimulation might have headaches. In very rare cases, a patient might experience severe headaches, nausea, and dizziness.

FAQ

Where can I get a transcranial Direct Current Stimulation (tDCS) device?

You can get ample tDCS devices on the internet. These devices might vary by cost, depending on the quality of the device.

Mave Health’s tDCS device - the ‘ARC’ helps people manage symptoms of mental health disorders like depression without any side effects.

How much does tDCS cost?

A good quality tDCS device is available for a range of Rs.1 lakh to 5 lakhs in India. There are multiple devices available on the internet claiming to be of the best quality but the cost varies based on the features present in the devices.

Before ordering one, make sure that the device is of standard quality and certified by the concerned authorities.

Can tDCS therapy be done at home as a treatment?

Yes. tDCS therapy can be done at home. tDCS is deemed safe to be used at home by users after understanding the functioning of the device. But before one begins with the therapy, it is advisable to consult a doctor to understand the technicalities of the device. If you are thinking of starting the tDCS therapy at home, make sure you know how to use the device correctly and set the parameters for stimulation correctly.

Take note of all the preventive measures to be followed if you suffer any adverse effects.

Can tDCS treat Anxiety?

The potential of tDCS to treat anxiety disorders is being explored. Clinical trials prove that tDCS is known to reduce anxiety symptoms, impact behavior during conflict, attentional bias for threat, vigilance to threatening stimuli, and perceived extent of negative emotions, such as fear, and anxiety.

Can tDCS treat depression?

tDCS has been used extensively for treating depression. More and more research reveals that tDCS helps to establish strong neural connections in the brain. It helps in regulating the mood and enhances the activity of neurons in the affected regions.

It promotes recovery without the risk of any side effects and helps to provide a holistic healing experience for the users.

Is tDCS FDA-approved?

The Food and Drug Administration (FDA) currently considers tDCS as a breakthrough device for treating mental health disorders, especially depression. product. The FDA is still learning more about the pros of this technology through clinical trials. However, it is a CE-certified technology and is being used by many people in the European Union. Many doctors offer tDCS as a treatment because of the definite proof it provides through research.

Conclusion:

While the words brain stimulation seem like something out of a sci-fi movie, tDCS shows that it is more of a light bulb than a lightning bolt for resolving mental health disorders and neurological issues. There is still a lot to know about tDCS and a lot more untapped potential for this technology. With proven efficacy and safety, it can be the shockingly effective solution you have been looking for.

The ARC-tDCS technology of Mave Health can provide a wholesome solution for treating depression and other mental health disorders. Every problem at Mave Health is approached with a personalized solution. If you know somebody who is struggling with depression, you can consult the psychologists and take the help of the tDCS technology.

References:

tDCS(Transcranial Direct Current Stimulation):How it Works, Benefits & Applications