Transcranial Direct Current Stimulation (tDCS)

What exactly is Transcranial Direct Current Stimulation (tDCS)?

Transcranial direct current stimulation is a form of neurostimulation that uses constant, low direct current delivered via electrodes on the head. It can be contrasted with cranial electrotherapy stimulation, which generally uses alternating current the same way.

There are 2 types of electrical currents: Alternating Current (AC) and Direct Current (DC).  The electricity that comes out of a normal wall plug for household use, is AC.  Domestic use batteries for toys or torch lights are DC.

tDCS uses DC current.

How does tDCS work?

Transcranial direct current stimulation (tDCS), is a non-invasive, painless brain stimulation treatment that uses direct electrical currents to stimulate specific parts of the brain.

The therapy works by delivering a low intensity electrical current to part of the brain responsible for abnormal pain sensation. This constant, low intensity current is passed through two electrodes placed over the head which modulates neuronal activity.

The treatment is not surgical and drug free. For patients this means less complications and less risk. If you are suffering from Fibromyalgia or Migraine you may benefit from this new technology.

There are two types of stimulation with tDCS: anodal and cathodal stimulation. Anodal stimulation acts to excite neuronal activity while cathodal stimulation inhibits or reduces neuronal activity.

Is it similar to Electro-convulsive Therapy (ECT) aka Electric-Shock Treatment?

It is important to note very early on, that tDCS is nothing like Electro-convulsive Therapy (ECT), more often known as “Electric Shock Treatment”.  With tDCS the patient is fully conscious, there is no use of any sedatives or relaxants, and it does not induce any seizures.

What is tDCS used for?

Recent studies support a therapeutic potential of tDCS in patients with chronic neuropathic pain (e.g. Fibromyalgia), Parkinson, stroke recovery, tinnitus (ringing in the ears), traumatic spinal cord injury, depression and other illnesses.

Although tDCS is still an experimental form of brain stimulation, it potentially has several advantages over other brain stimulation techniques. It is cheap, non-invasive, painless and safe. It is also easy to administer and the equipment is easily portable.

Several studies suggest it may be a valuable tool for the treatment of neuropsychiatric conditions such as depression, anxiety, Parkinson’s disease, and chronic pain. Research has also demonstrated cognitive improvement in some patients undergoing tDCS.

In Australia, the Royal Australia and New Zealand College of Psychiatrists (RANZCP), which is the governing body for Psychiatrists, has issued a tDCS Position Statement on the use of tDCS.  Currently, we only offer tDCS for the treatment of Fibromyalgia, chronic pain, and depression, which is in alignment with current available evidence.

Is tDCS safe?

Studies have shown that tDCS is safe, if administered properly using reliable devices.  The safety profile is superior to medications.  The safety profile has been the emphasis of the position statements of both the Royal Australia and New Zealand College of Psychiatrists (RANZCP) and the UK’s Royal College of Psychiatrists (RCPsych).

Procedure

Transcranial Direct Current Stimulation (tDCS)

Setting

Fully Outpatient

Application

Fibromyalgia, chronic pain, depression

Transcranial Direct Current Stimulation (tDCS) Standards

As with many new treatment modalities in the market, there is a danger of unregulated production and use of tDCS machines.  Over the last few years there have been many devices introduced in the open market, including do-it-yourself (DIY) kits available to purchase on the internet.  Such devices can have significant quality variability, and the characteristics of the current generated by these machines can be quite far from the required parameters of proper dosing.

Whilst tDCS itself is considered a safe procedure, it is only as safe as the quality of the device and the currents delivered, as well as the skill of the person administering it.

For this reason, the medical governing bodies have stepped in to regulate the use of tDCS.  Although it is regulated, there are still many manufacturers and practitioners (including non-medical practitioners) purchasing and administering tDCS without any quality control or oversight.

At The Shrink Company, we are committed to ensuring medical procedures like tDCS are administered properly in line with proper industry standards.

1. We are adequately accredited to National Safety and Quality in Healthcare Services (NSQHS) to ensure proper clinical governance and oversight

2.  We only use tDCS devices that are FDA (US) and TGA (Australia) approved as medical devices.

3.  Only Psychiatrists adequately credentialed and trained in the use and administration of tDCS can prescribe and administer tDCS.

4.  Only Mental Health Nurses adequately credentialed and trained in the use and administration of tDCS can administer tDCS under the supervision of the prescribing Psychiatrist.