In my previous post, I shared meta-analyses testing the use of home-based tDCS devices. Click here to access that post.
Professionals who administer tDCS in clinical settings lament the advent of home-based devices (which are quite affordable) for various reasons. One concern is that home treatment may be ineffective because proper electrode placement is critical for results. Electrode placement determines which brain regions are targeted. For example, for treating depression, there are various locations for electrode placement that have been documented in the literature. Typically, the dorsolateral prefrontal cortex or the anterior cingulate cortex are the targeted zones for treating depression (Suen et al). In their article, “Electrode Positioning and Montage in Transcranial Direct Current Stimulation,” DaSilva and colleagues reviewed protocols for electrode placement and stipulated that measurements must be taken of each patient’s skull to ensure proper placement. The size of electrodes is an important factor because larger electrodes will cover a greater area but smaller electrodes deliver more intense current to a specific spot. Saline solution is used to soak the sponges to ensure proper conductance. According to DaSilva and co-authors, left dorsolateral prefrontal cortex (anode) and supraorbital (cathode) are the most popular electrode placements for treating depression and pain (p. 8), however, more recent research has favored the F3/F4 montage for treating depression.
Any tDCS device that includes a fitting for the device or live video instruction in using the device will help ensure the safe use, avoidance of skin burns, and correct placement of electrodes to maximize effective treatment.
For additional protocols using home-based devices, my next post will provide a “bullet summary” including the history, desirability, treatment effectiveness in clinic and at home, and best practices for using tDCS to treat depression.
Citations: DaSilva, A. F., Volz, M. S., Biksom, M., & Fregni, F. (2011). Electrode positioning and montage in transcranial direct current stimulation. Journal of Visualized Experiments, 51, e2744. https://doi.org/10.3791/2744
Suen, P. J. C., Doll, S., Batistuzzo, M. C., Busatto, G., Razza, B., Padberg, F., Mezger, E., Bulubas, L., Keeser, D., Deng, Z., & Brunoni, A. R., (2021). Association between tDCS computational modeling and clinical outcomes in depression: Data from the ELECT-TDCS trial. European Archives of Psychiatry and Clinical Neuroscience, 271(1), 101-110. https://doi.org/10.1007/s00406-020-01127-w.
©Jennie Dilworth, Ph.D