[Brainmap] Felipe Fregni, MD, PhD; Leon Morales, MD Title: Title: EEG-guided tDCS - development of a closed-loop system

Felipe Fregni, MD, PhD; Leon Morales, MD

Department of Physical Medicine and Rehabilitation

Harvard Medical School

Spaulding hospital

Title: EEG-guided tDCS - development of a closed-loop system

Abstract:

Research in the field of noninvasive brain stimulation (NIBS) has been growth exponentially in the last two decades, from these investigations, two techniques stood as effective methods to deliver or induce electrical currents into the brain; transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS). Particularly, tDCS has showed its potential in clinical research as adjunct therapeutic technique for neuropsychiatric and psychological conditions, primarily because it’s safe and user friendly profile in the clinical environment. Furthermore, recent trials are exploring tDCS role as enhancer in cognitive functioning, however, most of the trials still using standardized methodology for tDCS electrode montage, current intensity and time for application as opposed to the development of individualized treatments, therefore, as tDCS transition from the controlled research environment to the always unpredictable clinical settings, a support technique must be used to ease therapeutic efficacy. Electroencephalographic signal analysis, using mathematical processing for quantitative assessment in the frequency and time domains, can be used to optimize and individualized tDCS treatments based on patient’s patterns of EEG abnormalities, thus quantitative EEG (QEEG) evaluations will represent an ideal tool for tDCS clinical applications per pathological condition. Recently, the electrical neuromodulation concept was expanded to embrace different applications of electrical polarization by making use of closed-loop systems. Closed-loop systems require a brain-computer interface that performs a dynamical analysis using different algorithms to record and process the data online and subsequently deliver an appropriate stimulus to the patient. Adding all these concepts, NIBS is becoming an option for many diseases where traditional treatments cannot improve patients issues, the focus of this talk is to present the current status of our research at the Neuromodulation Center and clinical experience of tDCS-QEEG guided applications.