we are in NEW YORK at a course on advanced neuromodulation from SOTERIX
Soterix produces “THE” tDCS devices for university research
Soterix develops and produces devices for research and was co-founded by the “godfather of neuromodulation” Prof. Marom Bikson.
The creative and scientific output of SOTERIX is astonishing, the devices are developed in close cooperation with scientists, the greatest value is placed on optimal support of research and studies, and therefore optimal control of compliance and real live research application.
“newes hit” is the high-definition neuromodulation and vagus stimulation,
an incredible technical progress also allows simultaneous mobile EEG measurement with simultaneous, freely programmable neurostimulation at up to 32 locations on the head.
On day 2 of this training, we will be presented with completely new possibilities for brain stimulation, which I don’t even have heard of yet and I will report on separately
mobile EEG with simultaneous mobile hd-tDCS stimulation
Now to the Workshop on hd-tDCS
With “high-resolution” tDCS, a central electrode is “surrounded” by 4 (or more) electrodes, which enables very precise and much more concentrated STIMULATION or INHIBITION of certain parts of the brain.
This is shown exactly in this picture
Here, in comparison, is the representation of the intensity and precision of brain stimulation with normal tDCS without “high definition”
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Workshop Day 1 Friday September 6th, 2024
approx. 40 participants, absolutely international, Europe, Asia, South America, Australia – only Africa was not represented
after the presentation of Soterix and its products by the CEO, co-founder and CTO PhD Abhishek Datta came the first research presentation
Presentation: hd-tDCS used in patient population
PhD Benjamin Hampstead, Univ. Michigan gave us some extremely important information in his talk, which was primarily dedicated to presenting research on hd-tDCS
2 mA maximal current is NOT THE LIMIT
The 2 mA treatment limit is actually arbitrary and not sufficiently covered by studies and mainly refers to a single study with around 33,000 applications from Mirom Bikson’s laboratory. It shows that 96% of all applications were carried out with < 2mA and there were no side effects even with the higher current strengths.
The statement that 2mA is the highest for treatment is therefore completely arbitrary and not supported by any scientific data, says Dr. Hamstead.
Dr. Hamstead has therefore caught up on basic research into higher current strengths and now uses up to 20 mA total current (in the form of multiple electrodes as hd-tDCS); he would use even more if the devices allowed this. SOTERIX wants to and will provide him with appropriately improved and upgraded devices for research.
more bang for the buck ….
4mA on one electrode can essentially be used without any problems, more is better. Redness of the skin is a good sign because it shows that current has actually flowed, perhaps give a little aloe vera gel during daily stimulation, in thousands of tests he has not had a single real side effect.
However, Dr. Hamstead uses the elegant SOTERIX electrodes that connect the head to the current flow with the help of GEL.
Much more importantly, due to different anatomy and conductivity conditions, the applied current strength arriving at the brain differs by up to 500%! That means 2mA is not 2mA for every patient, it differs enormously!
The brain can tolerate up to 120mA – but not the skin, so it is self-limiting anyway and will never be reached.
If you want to “increase the pressure by increasing the current flow” you can place 2 electrodes next to each other.
This enormously important basic research also involves checking how to optimally dose and measure the amount of current applied. I didn’t pay enough attention here and can’t reproduce it here
hd-tDCS home treatment – the right positioning
SOTERIX is working with him to develop constantly improved HD-tDCS electrodes.
Individual electrode systems for individual application profiles are 3D printed based on an MRI image of the patient, cost around 450 USD and are manufactured by SOTERIX itself with the appropriate electrodes in the location specified by the doctor or scientist.
NETWORK effects
It is important to stimulate entire NETWORKS, i.e. to stimulate those parts that “fire together” at the same time; this is easily possible with individual hd-tDCS.
Networks are anatomical or functional and mean that several centers in the brain have to work together to produce the corresponding calculation results
Research shows – if you test-build “disturbances” into the network, the stimulation loses a lot of its effectiveness!
proper diagnostics necessary before therapy
corresponding previous functional MRI (here, for example, an amyloid MRI), which then show the brain areas particularly affected in certain forms of dementia, are very helpful for applying individual therapies.
Here is the representation of a certain form of dementia: “occipito-visual dementia” in which atrophy in the occipital region occurs first, with disturbances in higher computational functions (interpretation of perception).
Patients can still see, but can no longer extract meaning from what they see.
Dr. Hamstead for around 60 euros (for research).
I would be curious to do some simple neurological tests on exactly those patients to see wether we could find the affected areas using „ancient tests of the forefathers of neurology“ – which is necessary for countryside GP family offices like mine. I really have no idea if we have a functional MRI in our country Austria?! And for sure I will not get an Amyloid MRI.
now this was an really excellent lecture that covers a lot of the basics, making Dr. Hamstead an enormously important asset for the entire tDCS community! Thanks to SOTERIX for making this lecture possible.
Lecture: 10,000 tDCS later – what have we learned and what’s next
Dr. Giuseppina Pilloni from New York University conducted a study with 700 patients with depression and a total of 10,000 tDCS treatments were carried out.
The home treatments are dramatically cheaper, the patients are trained and retrained via ZOOM, there are usually no problems after 3 training sessionsmore about using the devices correctly for depression
Around 36 treatments are necessary for the depression to be “cured”; the results then remain stable for at least 3 months. The patients should then carry out “maintenance stimulation” 3 times a week.
This message was almost “unbelievable” for many participants and Dr. Pilloni only released it very “hesitantly” – knowing full well that you can quickly become unbelievable if you produce results that are too good!
In this presentation, we were shown the advantages of the SOTERIX devices in terms of research and studies for home treatment. Patients receive a code to unlock the tDCS devices, after completing the treatment they receive a confirmation code from the device which must be entered into a website.
This ensures optimal compliance and corresponding reproducibility, absolutely brilliant: …. for research!
MOBILE EEG system
The Serbian company mBrainTrain was represented by Jelena Jovanovic and has launched a unique mobile EEG with up to 64 channels, which was introduced to the US market by SOTERIX including FDA approval, etc.
At least 10% of all studies with mobile EEGs are now carried out with this company.
Jelena is actually a marketing expert, but was able to perfectly present the many scientific studies carried out with the mBT and presented here
Exciting study about “micro-breaks” with mBT EEG
Boring work on a machine was “artificially” slowed down using a micro-break of 3-5 seconds between the individual iterations of the work.
The brain recovers during this time and the EEG shows that brain activity is around 30% higher than in the control group that worked without this break.
Representation of the work step in the test laboratory (1:1 replica of a factory situation) with representation of the brain activity while the work step is introduced
Extent of improvement in brain activity through “micro-pause”
This naturally increases the precision of the workers, reduces the risk of accidents and the frequency of errors.
Science Fiction: mobile HD-tDCS and simultaneous mobile EEG recording
Soterix, in collaboration with this company mBT, is developing a device with which 33 channels can be used precisely and simultaneously for HD-tDCS stimulation and – simultaneously – 32 channels EEG can be recorded.
MxN-GO: combined HD-TES and EEG
here the Soterix website for this device
MS Kamran Nazim is excited about this game-changer – device for research
Bryan is happy because he is being measured and stimulated as a dummy for this presentation
another Presentation: double-blind randomized application of vagus nerve stimulation in HIV alcoholics in MIAMI
Dr. Eric Porges PhD from the wonderful University of Florida in MIAMIgave an important lecture on a VAGUS stimulation study on HIV patients
VAGUS reduces NEURO-inflammation and circulating cytokines, improves the function of many organs
In the lecture we learned about the difficulties of conducting a study with this population group.
Compliance must be ensured by constant follow-up calls
small amounts of money must be paid for every little bit of cooperation
the people are very poor and neglected and need great compassion.
Dr. Eric Borges impressed me greatly with his loving and compassionate willingness to conduct serious scientific research with the “dregs” of our society!
Once again, just research – the results are unknown because it is “double-blind randomized”, even Dr. Eric cannot say how the study will turn out.
Once again, we have learned about the optimal devices from Soterix for research, every parameter is programmable, the devices control compliance optimally.
SOTERIX: ingenious brain stimulation devices
Extremely optimal for doctors and scientists: you can essentially programANY form of current (direct current, alternating current, noise, frequencies, pulses ….) and – on request – in the large hd-tDCS variant, administer up to 20mA total current – divided, of course, between multiple electrodes – in order to stimulate entire networks in the brain in parallel.
tDCS devices
- Here is the link to the “Clinic-tDCS device”
- Here is the link to the mobile device for home treatment (as part of studies)
- perfect for this is the SNAPHEADSET applicator, which always addresses the prefrontal region precisely, regardless of how the head is built
- really great: VESTIBULAR stimulator with suitable application electrodes, again with desktop and mobile stimulator design
- brilliant that there are special devices without electrodes for stimulating the spine – important for corresponding diseases of the spine and/or motor neuron
hd-tDCS devices
- hd-tDCS is carried out with a “splitter”, which divides the current supplied by the “simple, single region” device between the 5 electrodes
- much more optimal for therapy would be the “big solution” MxN-Pro with laptop, program and full programmability of multiple channels – as far as I can tell More than 30 parallel channels are possible, meaning that entire networks can be treated at once. SOTERIX then also produces the corresponding headsets with pre-printed electrodes.
I certainly can’t afford this device for the office, it is ideally suited to a large hospital with its own technician - The Super-Mercedes is of course the option to SIMULTANEOUSLY measure EEG and administer HD-tDCS mobile at the same time, this MxN GO EEG device is out of this world!
- Better suited (in terms of price) for a small practice is the mobile hd-tDCS version
- Together with a fully equipped HD-TDCS cap with 30 electrodes pre-installed and the you can get it in pretty much any size
freely programmable vagus stimulator
- the Soterix brain stem stimulator (vagus stimulator) is also a device that, like any other digital tDCS device, is fully programmable within every single parameter: stimulation frequency from 0.01 Hz to 5000 Hz, pauses, etc.
Application workshop
during the training we were familiarized with most of the devices and selected participants were given “test treatment”t”. A lot of emphasis was placed on practice and implementation
CONCLUSION of this first day of the SOTERIX Training
many of the devices presented are “science fiction”
Scienece Fiction because they are sooo versatile and advanced:
BUT – as a simple “user” – a simple general practitioner in a simple neurostimulation practice in rural Upper Austria, I think that most of my patients would fail to meet these requirements or that excessive training and maintenance work would have to be carried out on our part.
E.g.: the code to unlock the devices is 8 digits long, which none of my patients (neurologically impaired and mostly older) can ever remember, as they don’t even know their own insurance number – 4 digits and valid for life – nor do they know their own telephone number.
Target persons of this training here are certainly clinics and research institutes, universities, etc. The small “mobile” digital devices are suitable as practice devices “for us”, as are the older “analog” devices.
I will buy the vagus stimulator for myself immediately, as SOTERIX offers various applicator versions here offers, unfortunately I can’t manage with the “tragus pincer” myself
Suddenly the sun comes out in New York
you have to be able to show it, it’s also beautiful
New Yorkers always appear to be stressed and unfriendly – I just have been 2 weeks ago in Florida and then in St. Louis – there is definitly a difference. Lenna assumes it is because you hardly ever see the sun, not even the sky.
on Friday evening there was a get-together with a great dinner in the “Friedman’s – Wine-Bar”
here is a picture of our arrival the night before the conference
New York is almost deserted compared to before. Almost all the restaurants here in Midtown were empty last night at 9pm. I didn’t see any immigrants here, drug zombies on the street: n
DAY 2 – just as informative – follows in a separate article
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