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Harvard Medical School, Spaulding Rehabilitation Hospital

7 ARTICLES PUBLISHED IN JoVE

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Neuroscience

Electrode Positioning and Montage in Transcranial Direct Current Stimulation
Alexandre F. DaSilva 1, Magdalena Sarah Volz 2,3, Marom Bikson 4, Felipe Fregni 2
1Headache & Orofacial Pain Effort (H.O.P.E.), Biologic & Material Sciences, School of Dentistry, University of Michigan , 2Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 3Charité, University Medicine Berlin, 4Department of Biomedical Engineering, The City College of New York

Transcranial direct current stimulation (tDCS) is an established technique to modulate cortical excitability1,2. It has been used as an investigative tool in neuroscience due to its effects on cortical plasticity, easy operation, and safe profile. One area that tDCS has been showing encouraging results is pain alleviation 3-5.

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Medicine

Technique and Considerations in the Use of 4x1 Ring High-definition Transcranial Direct Current Stimulation (HD-tDCS)
Mauricio F. Villamar 1,2, Magdalena Sarah Volz 1,3, Marom Bikson 4, Abhishek Datta 1,4, Alexandre F. DaSilva *5, Felipe Fregni *1
1Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 2School of Medicine, Pontifical Catholic University of Ecuador, 3Charité University Medicine Berlin, 4The City College of The City University of New York, 5Headache & Orofacial Pain Effort (H.O.P.E.), Biologic & Materials Sciences, School of Dentistry, University of Michigan

High-definition transcranial direct current stimulation (HD-tDCS), with its 4x1-ring montage, is a noninvasive brain stimulation technique that combines both the neuromodulatory effects of conventional tDCS with increased focality. This article provides a systematic demonstration of the use of 4x1 HD-tDCS, and the considerations needed for safe and effective stimulation.

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Behavior

Simultaneous EEG Monitoring During Transcranial Direct Current Stimulation
Pedro Schestatsky 1,2,3, Leon Morales-Quezada 3,4, Felipe Fregni 3
1Programa de Pós-Graduação em Ciências Médica, Universidade Federal do Rio Grande do Sul, 2Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES), 3Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 4De Montfort University

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has shown initial therapeutic effects in several neurological conditions. The main mechanism underlying these therapeutic effects is the modulation of cortical excitability. Therefore, online monitoring of cortical excitability would help guide stimulation parameters and optimize its therapeutic effects. In the present article we review the use of a novel device that combines simultaneous tDCS and EEG monitoring in real time.

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Medicine

Home-Based Transcranial Direct Current Stimulation Device Development: An Updated Protocol Used at Home in Healthy Subjects and Fibromyalgia Patients
Fabiana Carvalho 1,2, Aline Patrícia Brietzke 1,2, Assunta Gasparin 1,2, Franciele Pereira dos Santos 2,3, Rafael Vercelino 4, Rafael Firmino Ballester 2,3, Paulo Roberto Stefani Sanches 5, Danton Pereira da Silva Jr 5, Iraci L. S. Torres 1,6, Felipe Fregni 7,8, Wolnei Caumo 1,2,9,10
1Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), 2Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), 3School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), 4Faculdade de Desenvolvimento do Rio Grande do Sul (FADERGS), Health and Wellness School Laureate International Universities, 5Biomedical Engineering Department, Hospital de Clínicas de Porto Alegre (HCPA), 6Pharmacology Department, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), 7Department of Physical Medicine and Rehabilitation, Harvard Medical School, 8Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, 9Pain and Palliative Care Service, Hospital de Clínicas de Porto Alegre (HCPA), 10Department of Surgery, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS)

This study provides an updated home-based tDCS protocol that enables subjects to receive the beneficial effects of tDCS at home with an easy to use device with settings to control the use and dosage, enhancing the feasibility for long-term use at home.

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Neuroscience

The Combined Use of Transcranial Direct Current Stimulation and Robotic Therapy for the Upper Limb
Marcus Yu Bin Pai 1, Thais Tavares Terranova 1, Marcel Simis 1, Felipe Fregni 2, Linamara Rizzo Battistella 1
1Department of Physical Medicine and Rehabilitation, Instituto de Reabilitação Lucy Montoro, 2Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School

The combined use of transcranial direct current stimulation and robotic therapy as an add-on for conventional rehabilitation therapy may result in improved therapeutic outcomes due to modulation of brain plasticity. In this article, we describe the combined methods used in our institute for improving motor performance after stroke.

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Neuroscience

Real-time Video Projection in an MRI for Characterization of Neural Correlates Associated with Mirror Therapy for Phantom Limb Pain
Faddi G. Saleh Velez 1,2, Camila B. Pinto 1,3, Emma S. Bailin 4, Marionna Münger 1, Andrew Ellison 5, Beatriz T. Costa 1, David Crandell 6, Nadia Bolognini 7,8, Lotfi B. Merabet 4, Felipe Fregni 1
1Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, 2University of Chicago Medical Center, Department of Neurology, University of Chicago, 3Department of Neuroscience and Behavior, Psychology Institute, University of Sao Paulo, 4The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 5Center for Biomedical Imaging, Department of Anatomy and Neurobiology, Boston University School of Medicine, 6Spaulding Rehabilitation Hospital, Harvard Medical School, 7Department of Psychology & Milan Center for Neuroscience, University of Milano-Bicocca, 8Neuropsychological Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Auxologico Italiano

We present a novel combined behavioral and neuroimaging protocol employing real-time video projection for the purpose of characterizing the neural correlates associated with mirror therapy within the magnetic resonance imaging scanner environment in leg amputee subjects with phantom limb pain.

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Neuroscience

Measuring Contralateral Silent Period Induced by Single-Pulse Transcranial Magnetic Stimulation to Investigate M1 Corticospinal Inhibition
Ingrid Rebello-Sanchez 1, Joao Parente 1, Kevin Pacheco-Barrios 1,2, Anna Marduy 1, Danielle Carolina Pimenta 1, Daniel Lima 1, Eric Slawka 1, Alejandra Cardenas-Rojas 1, Gleysson Rodrigues Rosa 1, Kamran Nazim 3, Abhishek Datta 3,4, Felipe Fregni 1
1Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 2Universidad de Investigación para la Generación y Síntesis de Evidencia en Salud, Universidad San Ignacio de Loyola, 3Research and Development, Soterix Medical, 4City College of New York

Contralateral silent period (cSP) assessment is a promising biomarker to index cortical excitability and treatment response. We demonstrate a protocol to assess cSP intended for studying M1 corticospinal inhibition of upper and lower limbs.

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