Transcranial direct current stimulation Application
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Transcranial direct current stimulation Application

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neurocare helps people by providing sustainable therapies for mental disorders, chronic pain and rehabilitation. As a specialist in non-invasive neuromodulation, neurocare offers the technology, training and clinical expertise for safe and well-researched therapies. By measuring and modulating brain activity, significant and lasting improvements in symptoms and quality of life can be achieved. The interventions can improve the outcome of standard therapies and can also help when other therapies fail or are not feasible.

DC-STIMULATOR MOBILE

Neuromodulation with tDCS? Transcranial direct current stimulation (tDCS) is a non-invasive, well tolerated treatment method. A weak electrical direct current acts on the brain through two electrodes attached to the head. Studies show positive effects in a range of indications. tDCS is easy to use, painless and safe. In combination with other therapies, tDCS can enhance their positive effects. Depending on the voltage, duration, polarity and location of the electrodes, the applied current can have an inhibiting or stimulating effect. tDCS modifies the resting membrane potential and the...

Depression Studies have demonstrated that in depression there is often asymmetric activity of neuron populations in the prefrontal cortex. In the left hemisphere (dorsolateral prefrontal cortex, DLPFC) decreased neuronal activity has been observed. This can be compensated with anodal left side tDCS. Improvement in cognitive performance is observed in relatively few sessions. Studies show antidepressant effects are generally noticed after 2 to 3 weeks of treatment. tDCS can be used in parallel to or complimentary to other conventional therapies (e. g. pharmacotherapy or psychotherapy). Level...

Suitable electrode positions with evidence level A: ■ Anode: left DLPFC (F3) ■ Cathode: right supraorbital (FP2) Source: Lefaucheur JP et al 2017, Aust S et al. 2015 ■ Anode: left DLPFC (F3) ■ Cathode: or right DLPFC (F4)

Addictive Disorders Addictive disorders are known to be challenging to treat. Studies observe there is disturbed cognitive control in relation to cravings and the consumption of addictive substances. This disorder of cognitive control is reflected in a change in DLPFC activity. By stimulating the DLPFC, risk-taking and addiction can be alleviated which is found to reduce craving. Level of evidence = Level B (probably effective)

Anode: right DLPFC (F4) Cathode: left DLPFC (F3) Stim. intensity: Source: Lefaucheur JP et al. 2017, Klauss J et al. 2018, Coles AS et al. 2018, Batista E et al.

In studies of patients with fibromyalgia, migraine, chronic, postoperative or neuropathic pain, tDCS treatment with anodic stimulation over the motor cortex (M1) is found to reduce perceived pain. In relatively few sessions, improvements have been observed which have persisted after treatment. Level of evidence = Level B (probably effective), for: • neuropathic pain • fibromyalgia • migrain • postoperative pain

Anode: left hemisphere (M1; C3) or contra- lateral (C4) to the side of the body Cathode: right supraorbital (Fp2) or Fp1 (depending on side of pain) Stim. intensity: Source: Lefaucheur JP et al. 2017, Przeklasa-Muszynska A et al. 2017, Silva AF et al.

Motor Disorders A stroke often leads to the loss or disruption of motor areas of a hemisphere. As a result, the damaged hemisphere can no longer control the movement of contralateral limbs. The undamaged hemisphere tries to compensate for the deficits of the other hemisphere through increased activity. In the long term, the dominance of the undamaged hemisphere impairs the regeneration of the damaged hemisphere. tDCS can inhibit the activity of the undamaged hemisphere and increase the activity of the damaged hemisphere. The aim is to restore the balance of the control processes in both...

Possible electrode positions with evidence level B for motor disorders after stroke: ■ Anode: same hemisphere of the lesion (C3 or C4, relevant for lesion) A ■ Cathode: contralateral to lesion (C3/C4) or supraorbital Subacute: Andrade SM et al. 2017 Chronic: Bolognini N et al. 2011, Lindenberg R et al. 2012 ■ Anode: same hemisphere of the lesion (C3 or C4, relevant for lesion) ■ Cathode: supraorbital in healthy hemisphere (Fp2 oder Fp1) A2 Subacute: Andrade SM et al. 2017, Khedr EM et al. 2013 Chronic: Rocha S et al. 2016, Ilic NV et al. 2016 ■ Anode: supraorbital in hemisphere of lesion...

Cognitive Deficits Memory and cortival activity Impaired cognitive performance is often observed in patients with neurological disorders. While disturbances of attention and memory are prominent, executive functions or spatial-perceptive functions are also often impaired. Such disorders may be caused by brain damage or imbalances in neurochemical transmitters. The impairments can be such that the patient may require full-time or partial everyday life supports. Combining tDCS with cognitive therapies (e.g. computer-assisted therapies) can improve attention and memory faster and more...

Anode: left DLPFC (F3) Cathode: right supraorbital (Fp2) or right DLPFC (F4) Stim. intensity: Source: Lefaucheur JP et al. 2017, Ruf SP et al. 2017, Mattioli F et al. 2016, Sacco K et al.

Cognitive Deficits Learning and information processing Cognitive deficits are symptoms of many psychiatric disorders. Affected are e. g. executive functions, working memory, attention and information processing. Deficits in learning, thinking and problem solving become visible in everyday life. These impairments represent a handicap for patients when it comes to finding their way back into working life. Even coping with the demands of everyday life can already overtax patients. The combination of tDCS treatment with cognitive training can have a positive effect on the psychiatric...

With MyBrainTraining® a tool has been created that is specially tailored to the needs of psychiatric patients. Prof. Dr. Kawashima was able to show that MyBrainTraining® exercises lead to cortical activation. Regular training leads to significant cognitive and behavioural improvements in the patients‘ everyday life (Moritz et al. 2015)