Home-Based Transcranial Direct Current Stimulation Device Development: An Updated Protocol Used at Home in Healthy Subjects and Fibromyalgia Patients

Carvalho, Fabiana; Brietzke, Aline Patrícia; Gasparin, Andrese Aline; Santos, Franciele Pereira dos; Vercelino, Rafael; Ballester, Rafael Firmino; Sanches, Paulo Roberto Stefani; Silva, Danton Pereira da; Torres, Iraci L. S.; Fregni, Felipe; Caumo, Wolnei

doi:10.3791/57614-v

Cited by 7 publications

(3 citation statements)

References 6 publications

(6 reference statements)

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“…The sample consisted of adult individuals who had suffered a stroke, who were subjected to different treatment alternatives based on the stimulation of the primary motor cortex (M1) with the intention of achieving changes in the motor skills of these patients through a phenomenon of neuromodulation (Carvalho et al, 2018;Cruccu et al, 2016). In general, it is possible to draw conclusions similar to the results obtained in other previous studies along the same lines (Allman et al, 2016).…”

Section: Discussionmentioning

confidence: 92%

Transcranial direct current stimulation in physical therapy treatment for adults after stroke: A systematic review

Rodríguez-Huguet,

Ayala-Martínez,

Vinolo-Gil

et al. 2024

NRE

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BACKGROUND: Stroke is a clinical syndrome that can cause neurological disorders due to a reduction or interruption in the blood flow at the brain level. Transcranial direct current stimulation (TDCS) is a non-invasive electrotherapy technique with the ability to modulate the function of nervous tissue. OBJECTIVE: The aim of this review is to analyze the effects derived from the application of the TDCS for post-stroke patients on functionality and mobility. METHODS: The data search was conducted in PubMed, PEDro, Cochrane Library, Web of Science and Scopus between July and August 2023. The search focused on randomized clinical trials conducted in the period of 2019–2023, and according to the selection criteria, seven studies were obtained. RESULTS: The results found are mainly focused on the analysis of the scales Fugl-Meyer Assessment for Upper Extremity and Wolf Motor Function Test. CONCLUSION: The application of TDCS presents benefits in post-stroke individuals on functionality, mobility and other secondary studied variables.

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Section: Discussionmentioning

confidence: 92%

Transcranial direct current stimulation in physical therapy treatment for adults after stroke: A systematic review

Rodríguez-Huguet,

Ayala-Martínez,

Vinolo-Gil

et al. 2024

NRE

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“…4), after finding the optimum tES protocol using a closed-loop tES-fMRI data collection, the resultant optimum individualized parameters (e.g., stimulation intensity, phase difference, stimulation frequency) could be applied for each person over consecutive multiple offline tES sessions or as needed with home-based devices for clinical utility in real-world applications. There are recent advances in the feasibility of individualized portable or home-based tES [50,[127][128][129], but the clinical applicability of online personalized neuromodulation followed by home-based tES using the identified personalized protocol should be tested in future trials.…”

Section: Challenges Of Closed-loop Tes-fmri Systemsmentioning

confidence: 99%

Closing the loop between brain and electrical stimulation: towards precision neuromodulation treatments

et al. 2023

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One of the most critical challenges in using noninvasive brain stimulation (NIBS) techniques for the treatment of psychiatric and neurologic disorders is inter- and intra-individual variability in response to NIBS. Response variations in previous findings suggest that the one-size-fits-all approach does not seem the most appropriate option for enhancing stimulation outcomes. While there is a growing body of evidence for the feasibility and effectiveness of individualized NIBS approaches, the optimal way to achieve this is yet to be determined. Transcranial electrical stimulation (tES) is one of the NIBS techniques showing promising results in modulating treatment outcomes in several psychiatric and neurologic disorders, but it faces the same challenge for individual optimization. With new computational and methodological advances, tES can be integrated with real-time functional magnetic resonance imaging (rtfMRI) to establish closed-loop tES-fMRI for individually optimized neuromodulation. Closed-loop tES-fMRI systems aim to optimize stimulation parameters based on minimizing differences between the model of the current brain state and the desired value to maximize the expected clinical outcome. The methodological space to optimize closed-loop tES fMRI for clinical applications includes (1) stimulation vs. data acquisition timing, (2) fMRI context (task-based or resting-state), (3) inherent brain oscillations, (4) dose-response function, (5) brain target trait and state and (6) optimization algorithm. Closed-loop tES-fMRI technology has several advantages over non-individualized or open-loop systems to reshape the future of neuromodulation with objective optimization in a clinically relevant context such as drug cue reactivity for substance use disorder considering both inter and intra-individual variations. Using multi-level brain and behavior measures as input and desired outcomes to individualize stimulation parameters provides a framework for designing personalized tES protocols in precision psychiatry.

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“…In special circumstances when the pad electrode is separated from the scalp by cream/ gel without the use of sponge 21 , caution is required to prevent direct electrode-skin contact leading invariably to a burn 14 . An alternative less common method for tDCS uses an elastic cap 22,23 , which depends on subject specific head deformation not distorting electrode position, and risks saline spread and bridging under the cap (not visible to the operator). In comparison to conventional rubber-band or elastic-cap based techniques, the modern tDCS technique presented here makes the critical electrode preparation and positioning steps more robust and reliable.…”

Section: Introductionmentioning

confidence: 99%

Updated Technique for Reliable, Easy, and Tolerated Transcranial Electrical Stimulation Including Transcranial Direct Current Stimulation

Borges

Dufau

Paneri

et al. 2020

JoVE

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Transcranial direct current stimulation (tDCS) is a noninvasive method of neuromodulation using low-intensity direct electrical currents. This method of brain stimulation presents several potential advantages compared to other techniques, as it is noninvasive, cost-effective, broadly deployable, and well-tolerated provided proper equipment and protocols are administered. Even though tDCS is apparently simple to perform, correct administration of the tDCS session, especially the electrode positioning and preparation, is vital for ensuring reproducibility and tolerability. The electrode positioning and preparation steps are traditionally also the most time consuming and error-prone. To address these challenges, modern tDCS techniques, using fixed-position headgear and pre-assembled sponge electrodes, reduce complexity and setup time while also ensuring that the electrodes are consistently placed as intended. These modern tDCS methods present advantages for research, clinic, and remote-supervised (at home) settings. This article provides a comprehensive step-by-step guide for administering a tDCS session using fixed-position headgear and pre-assembled sponge electrodes. This guide demonstrates tDCS using commonly applied montages intended for motor cortex and dorsolateral prefrontal cortex (DLPFC) stimulation. As described, selection of the head size and montage-specific headgear automates electrode positioning. Fully assembled pre-saturated snap-electrodes are simply affixed to the set position snap-connectors on the headgear. The modern tDCS method is shown to reduce setup time and reduce errors for both novice and expert operators. The methods outlined in this article can be adapted to different applications of tDCS as well as other forms of transcranial electrical stimulation (tES) such as transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNS). However, since tES is application specific, as appropriate, any methods recipe is customized to accommodate subject, indication, environment, and outcome specific features.

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Home-Based Transcranial Direct Current Stimulation Device Development: An Updated Protocol Used at Home in Healthy Subjects and Fibromyalgia Patients

Cited by 7 publications

References 6 publications

Transcranial direct current stimulation in physical therapy treatment for adults after stroke: A systematic review

Transcranial direct current stimulation in physical therapy treatment for adults after stroke: A systematic review

Closing the loop between brain and electrical stimulation: towards precision neuromodulation treatments

Updated Technique for Reliable, Easy, and Tolerated Transcranial Electrical Stimulation Including Transcranial Direct Current Stimulation

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