NYC Neuromodulation 2017

Last weekend I was in New York City for the NYC Neuromodulation 2017 Conference (from Neuromodec).

Overview of the conference

Some of the pioneers and the big names in brain stimulation were present at the conference, like Michael Nitsche, Eric Wassermann, Mark Gorge, Marom Bikson, Adam Woods, etc.

The conference focused heavily on tDCS and TMS, but addressed many fields of application for brain stimulation like epilepsy, parkinson, aphasia, cerebral palsy, cognitive training, depression, sport & performance, etc. The agenda was very packed, but the content was very good. Despite being quite scientific, many different angles were discussed aside from the underlying science, like the media, clinical applications, healthcare system (in the US), industry, fail results, etc. It was scientific, but accessible. Thumbs up to the organizers for making it specific, yet inclusive.

What I loved about the conference is that it felt real. It didn’t feel like a show for money, a show for VCs or for the media. It was about people in the field acknowledging the potential of brain stimulation, but realistically speaking about the current state of the field. And about the fact that we don’t yet understand what’s happening under the hood, during brain stimulation. Given the size of the conference, everybody was very accessible, so it was the perfect occasion to have a discussion with anyone you’d like to talk to. Which is not always the case with bigger conferences, where some of them just seem to disappear after their talk.

Venue

Before jumping right in, I need to acknowledge the choice of the venue. City College in NYC is absolutely gorgeous.

Practical Demo(s)

I enjoyed the practical demos given by experts in the field like Michael Nitsche and Adam Woods showing how to do tDCS and how not to do tDCS, giving clear examples of what to avoid and why. All that while having a good interaction with the audience surrounding the demo asking questions.

“Do not use the ‘Oreo Cookie’ approach.” -Adam Woods.

For those more technical, read the following, otherwise skip this section ;)

Here are some advices from Adam Woods: Do not use the “Oreo Cookie” approach where you soak your sponge in your saline solution and squeeze it to remove the extra. Because it over saturates, it’s dripping, it’s very “subjective” and hard to reproduce. Get a syringe and put 8mL of saline solution on your sponge and make sure to also get the corners. Do that prior to insert the electrode in between the 2 layers. If it’s dripping wet, that’s bad (you’re doing it wrong!). You should not have to use a tower on the patient’s neck.

He also pointed out that if it’s dripping wet and you report using a 5x5 electrode, it’s actually false. Because the whole “wet” area is now your electrode [size]. It’s obviously impossible to reproduce.

He also suggested to use Ten20 paste instead of saline solution, because it’s more stable over time. BUT, it takes more time to get the impedance right. You need to apply it ~20 min prior to the actual stimulation. Once you get the impedance right though, you are good for hours and it’s stable.

Hair is your biggest enemy, of course. Good hair prep will help. (any electrical related technique; tDCS, EEG, etc. have hard time with hair)

He also warned to check for drift. Mark the initial position & mark the end position. Position Matters.

His presentation (or a very similar one) was published few months ago on DIY tDCS website, here.

At Home Use

The potential of tDCS at home is very interesting because as opposed to other technologies like TMS, it’s portable and low cost.

The user needs to know exactly where to place the electrodes, what equipment and what protocol (dosage) to use. This is why Remotely-Supervised-tDCS (RS-tDCS) has gain in popularity and is being explored by some groups. The researcher / clinician / professional will do a live remote video session with the subject / patient and will confirm that everything is safe, well positioned, and according to the plan.

Brain State Matters

One concept that came back couple of times was the fact that the “brain state” the subject is in, during stimulation, will affect the result.

Roy Hamilton talked about it more in details during his presentation, highlighting the high variability of tDCS studies and the importance of considering the mental state (intra-subject variability) and also the baseline of the subjects (between-subjects variability). Talking about concepts like to “prime” training with a related task during stimulation. Some studies show that non-experts benefit more from the stimulation, but other studies show that in other cases expert benefit more (riches get richer). Therefore, baseline (current expertise) matters.

It doesn’t always work

I appreciated the fact that some researchers also presented negative results.

David Putrino presented a tDCS study on athletes trying to push their limits beyond fatigue that concluded with no improvement.

Vince Clark presented a tDCS study trying to improve fluid intelligence, with 204 participants, that resulted in no improvement.

“We now know more about how not to do tDCS” -Vince Clark.

It’s important to also discuss about the negative results. In the literature we find mainly positive results, but so many studies with negative results go unpublished. This kind of conference offers a great opportunity to discuss about these negative results and help save time, energy and money, resulting in accelerating the evolution of the field.

Media & Communications

Brain Hacking, Brain Zapping, Mind Control, etc. We’ve all seen over hyped — clickbait — full of buzzwords — titles in the media.

“We [the media] only have few seconds to get people’s attention before they move on.” -Eliza Strickland

I was very happy to see a panel on that specific subject, asking how we can improve the communication and therefore the public perception of the field. The panel was moderated by Eliza Strickland an editor for IEEE Spectrum. The panel agreed that we all need to be more careful with the messaging and how it’s being presented, from the researchers and scientists to the journalists and bloggers. Easy to say… But the problem is not just about tDCS and brain stimulation, rather about the whole high-speed media culture.

An interesting question was raised: “do the public really care about the details?” Or are people only looking for big highlights they can share?

Conclusion

I’m definitely looking forward for the next edition! And wearing my NeuroTechX hat, I’m definitely looking forward for more collaborations with Neuromodec.

If you’ve read until here and you want some more, watch my short interview with Marom Bikson and the live Halo Sport demo with Andrea Coravos.

Don’t forget to check out the pictures from the event!

-Yannick.

I have no conflict of interest with Neuromodec nor the conference. I was offered a press pass to attend the event, but I am reporting my own personal view and opinion as both a neurotech enthusiast and a PhD student.