Friday, May 17, 2013

Will tDCS ever be a bottom up, widespread success?





tDCS has been known for a number of years now, and for any intrepid explorer, with a little knowledge of circuit theory, but most importantly a little bravery, a DIY tDCS is easily within reach. Simple designs can be found on this blog here, and also at Brent's Speakwisdom blog. But it appears the number of intrepid explorers is not that really big when it comes to the general population. Hence some people have decided to buy a device.

At www.alltdcs.com, you can find the currently available devices that will provide the necessary regulated current to implement a tDCS treatment. It is somewhat confusing as some "off label" devices are much more expensive and have been designed and tested for a different function. And then there are less expensive units that have started to be released with novel ways to try to circumvent the lack of FDA regulation on tDCS medical devices.

Since devices are somewhat easy to make, and easy to purchase, it makes me wonder why more of the population is not clambering for tDCS. Again on speakwisdom, there has been a discussion about the likelihood of a counter top tDCS device. Is it likely? Who would benefit? Will it ever happen?

The typical route for a medical device is years of solid successful research by the research community; then the FDA gets involved and undertakes longer, larger, clinical studies to show efficacy, and ensures public safety. After all that, and many, many years later, if there is a FDA regulation, then the testing to achieve regulation is often prohibitive except for large companies. Only much later, can companies piggy back on the work of early adopters and the price becomes cheaper. Think of the ease and cost of TENS units.

This is the likely path of tDCS. But tDCS may be different: because of its ease in implementing a working DC regulator, and the demand that may grow faster than the FDA can react (with creative, inexpensive devices and kits for sale), there may be a bottom up movement that has no precedent (the closest may be the vitamin and supplement industry). It would be great to see a different path happening for tDCS but first, a large chunk of the population has to be practising first.

I doubt that will happen. Not so much because of the lack of money to be made from large companies (companies always find a way to make a lot of money), but from the "don't try this at home" syndrome. It is difficult to read any media about tDCS and not see the experts say, "don't try this at home", "it is dangerous", "it is your brain you are experimenting with". It may take years, perhaps a lifetime, before it is generally accepted that a small electrical current, which really doesn't do much to skin and muscle, can have a dramatic and exciting affect on the brain and nervous system. Can that little itch, and slight burn if you like it at 2mA, really cause a change in mental capabilities of a person? Amazingly yes.

What is the cause of the "don't try this at home". First I don't think the research community is intentionally dragging their feet, but they are partly to blame for the slow acceptance. They are consistently publishing positive results, and follow along the status quo of research, more clinical studies, FDA regulation, etc. By the nature of their business, researchers need to be conservative to get more funding.

I think the biggest culprit in "don't do this at home" is the cultural fear of electricity generally, and particularly the cultural fear of providing electric current through the brain. I am not sure how to make the general population more comfortable with electricity and it's amazing potential (the Biocurrent kit was intentionally designed for simplicity and ease) but a widespread tDCS use that is not just prescribed by the doctor will only occur if this fear is washed away in truths and honesty about tDCS.

And if you "do try this at home", be knowledgeable and be safe.