Neuroprime is an electrical stimulation device which alters brain function

1. tDCS therapy for depression
01608 643922
www.neuroprime-tdcs.com

2. What is it?
Neuroprime is an electrical stimulation
device which alters brain function. It
sends a minute current (<2mA) through
the skull into the cortex.
The technology is known as
Transcranial Direct Current
Stimulation. (tDCS) Evidence from
hundreds of scientific studies suggests it
could be safe and effective therapy for a
wide range of conditions including:
Depression and anxiety,
Movement and speech disorders (especially after stroke)
Memory problems
Chronic pain
Tinnitus
Addiction
Eating disorders
Obsessive compulsive disorder
Dementia
Schizophrenia
It has also been shown to enhance mood and cognitive
performance in healthy people.
1

3. Background
Transcranial Direct Current Stimulation (tDCS) is basically very simple
and very old. Galvini used a similar technique to make frogs’ legs
twitch. Right up until the 1960s it was used to treat melancholia,
although at that time nobody was
sure how, or why, it worked.
When psychoactive drugs came
along tDCS was, for a while,
forgotten. Around 2010 however,
researchers started to use it again, mainly to help
fill in the brain function map that was being created
by imaging technologies such as PET and fMRI.
In the course of research it became clear that tDCS could also
help relieve symptoms of brain disorders by causing subtle but
lasting changes in brain function.1 Researchers also
tried it on healthy people, and found that it could enhance
certain types of experience and cognition. The US research institution
DARPA claims it has halved the length of time required to train drone
pilots, and others have found improved creativity and
maths ability. 2
PubMed now lists nearly one thousand tDCS studies in peer-reviewed
Journals, a majority of which show it to have beneficial effects. No
significant safety issues have emerged.
1) Therapeutic effects of non-invasive brain stimulation with direct currents (tDCS) in neuropsychiatric
diseases.Neuroimage. 2013 Jun 4. pii: S1053-8119(13)00627-7. doi: 10.1016/j.neuroimage.2013.05.117
Kuo MF, Paulus W, Nitsche MA.
2) Neuroenhancement: Enhancing Brain and Mind in Health and in Disease.
Neuroimage. 2013 Sep 12. pii: S1053-8119(13)00938-5. doi: 10.1016/j.neuroimage.2013.08.071.
Clark VP, Parasuraman R.
2

4. The single most researched application is for treatment of
depression.
Four of 6 phase II clinical trials and one recent meta-analysis have shown that it
reduces depressive symptoms. The effect appears to be long-lasting and possibly
permanent.1
One trial reported 69% improvement in mean Hamilton Depression Rating Scale
(HDRS) scores after five sessions of active tDCS over 1.5 weeks, compared with
30% improvement in the sham group. 2 Another showed improvement of 40.5%,
compared to 10.4% in the sham group, after 10 consecutive weekdays of
treatment 3 The improvements are lasting, and comparable to anti-depressant
drugs such as Prozac. They also set in sooner.4. A recent meta-analysis of 108
studies indicated that active tDCS results in reduction of symptom severity of
approximately 29% and that the beneficial effects persist for at least a month.5
Some studies have found an effect comparable to anti-depressant drugs 6 and
tDCS has also been found to augment pharmacological treatment and to work for
patients who have not responded to other treatment 7
Refs:
1) Fregni et al, “ Transcranial direct current stimulation for the treatment of major depressive dsorder: A
summary of preclinical, clinical and translational findings” Psychology Medicine. 2012 Jan
2) Fregni F,et al “Treatment of major depression with transcranial direct current stimulation.” Bipolar Disord 2006;
8:203-4.
3) Boggio et al “A randomized, double-blind clinical trial on the efficacy of cortical direct current stimulation for
the treatment of major depression.” J Neuropsychopharmacol. 2008 Mar;11(2):249-54
4) Rigonatti et al “Transcranial direct stimulation and fluoxetine for the treatment of depression.” Eur Psychiatry
2008; 23:74-6.
5) Kalu et al “Transcranial direct current stimulation in the treatment of major depression- a meta-
Analysis” Psychol Med. 2012 Sep;42(9):1791-
6) Brunoni et al The sertraline vs. electrical current therapy for treating depression clinical study: results from a
factorial, randomized, controlled trial
JAMA Psychiatry. 2013 Apr;70(4):383-91.
7 Dell’asso et alAugmentative transcranial direct current stimulation (tDCS) in poor responder depressed
patients: a follow-up study )CNS Spectr. 2013 Aug 20:1-8.
3
tDCS in Depression

5. Treatment
Neuroprime therapy is given as a course of sessions, each one lasting
about 20 minutes . Most people will get optimum benefit from five to ten
sessions, which may be given daily, or two or three times a week. These may be
followed if necessary, by the occasional “booster” session.
Sessions are simple to set up. The therapist places the saline-soaked
electrodes on the client’s scalp, holding them in place with the Neuroprime
headset or the Neuroprime headband (similar to a sports or yoga band). Once in
place, the machine is turned on with a single click (to activate default settings) or
by setting a new protocol using the buttons on the device. The current can be set
for any strength up to 2.2mA.
New patients should be started on a
low dose (<1Ma).
Neuroprime ramps up to the
pre-set current over a short duration
(default ten seconds) and ramps down
at the end before turning off
automatically. The patient or therapist
can abort the treatment at any time
with a single button press
Most patients report tingling or itching under the
electrodes which fades after a few minutes. Some report a
burning sensation, but there is no temperature rise and when used properly, there
is very little risk of skin irritation continuing after the session.
Patients should be encouraged to do some exercise to minimise
depressive ideation during treatment, as tDCS is thought to “select” active
neurons for stimulation and this may have a better effect If the person combines it
with suitable brain training.
4

6. How does it work?
anodecathode
tDCS transmits current via two
or more scalp-mounted electrodes. The
current flows from the anode (positive
pole) to the cathode (negative).
Neurons in the field of the current are
subtly changed so that they become
more (or less) sensitive to stimuli. Those
beneath the anode are stimulated, those
beneath the cathode are inhibited.
Synaptic activity is not generally affected during treatment
(unlike TMS and ECT). Rather the changes are thought to occur as a
result of alterations in the neurons’ membranes, making ion channels
more (or less) likely to open and therefore affecting their sensitivity
to subsequent stimuli.
Stimulating/inhibiting different parts of the brain has different effects .
For depression, Neuroprime targets dorsolateral prefrontal cortex
(F3/F4) bilaterally, with anode on the left. Other montages are
possible using the Neuroprime headband.
5

7. Safety and tolerance
tDCS has been used by thousands of people during
closely monitored research projects. More than 950 such
investigations have now been published and no serious adverse
effects have been reported.
The only known adverse effect is skin irritation from the
electrodes. Most patients report tingling or pricking under the
electrodes for the first minute or two or treatment. Headaches,
nausea and tiredness are reported during and after treatments at
similar rate to placebo.
Two incidents have been reported of manic
episodes shortly after treatment in patients with pre-existing
diagnoses of bipolar disorder.
Treatment is contraindicated in people with metal
inserts in the upper body or a history of seizures
6

8. Use and regulation
In Europe and most other countries there are no
regulations governing the use of tDCSstrictions on the use of
tDCS. Anyone may legally use Neuroprime on themselves or
anyone else.
In the US tDCS is approved by the FDA for use as an
investigational technique, or by medical practitioners. FDA
regulation has led to a flourishing DIY tDCS community.
Training:
Although it is relatively easy to use some training is advised
because Neuroprime only works when it is directed at the
correct cluster of brain cells.
On-site training for therapists will be provided at
cost for a limited period.
7

9. Her 1998 title “Mapping the Mind” was the first
to make neuroscience intelligible to non-experts.
It has been translated into 19 languages and its
latest edition is still read throughout the world.
Her other titles include “Exploring Consciousness”
“Multiplicity – the new science of personality”,
“Boost Your Memory” and “The Brain Book”.
Rita has won many awards for her writing, including on three
occasions the Medical Journalists’ Association award for
Excellence. She lectures on brain science throughout the
world, and has an honorary doctorate from Leuven University.
Rita started Neuroprime in frustration at the length of time it
was taking to make tDCS known about, and available, outside
research laboratories.
8
About Neuroprime
The founder of Neuroprime is
Rita Carter, author of several
best-selling and respected
books about brain research and
psychology (ritacarter.co.uk).

10. What are the effects?
The effect of Neuroprime varies according to how
accurately the electrodes are placed and the condition or
function being treated. Individuals also differ in their response.
For depression, studies indicate that Neuroprime has
beneficial effects comparable to treatment with sertraline or
CBT. There is evidence that it augments these therapies and
also increases the effect of brain training games
tDCS has been shown to increase neuronal excitability in
target brain areas for up to three months post-treatment. In
most cases this is reflected by increased positive affect.
9

11. Our brains contain billions of
interconnected electrical cells
called neurons . When a neuron
is heavily stimulated it fires, and
sends an electrochemical signal
to other neurons, stimulating
them in turn. Synchronous firing
in clusters of neurons produces
sensations, thoughts, emotions
and behaviour.
Mode of action
Neuronal firing occurs when the
electrical potential between the
inside of the cell and the outside
reaches a critical level.
Minute channels in the cell membrane then open up suddenly,
allowing charged particles to flow in and out . This evens the
charge and returns the cell to resting state.
Neuroprime alters the resting potential of neurons in the
cortex, making them more or less likely to fire (depending on
whether the stimulation is from anode or cathode) given a
normal stimulus. By locating the electrodes over neurons
which either need stimulating or inhibiting, experience can be
changed. Stimulating neurons concerned with reward, for
example, enhances mood
While inhibiting those concerned with fear can decrease
anxiety
.

12. Mode of action 2
Neuronal firing
occurs when the
electrical potential
between the inside
of the cell and the
outside reaches a
critical level.
Minute channels in the cell membrane
then open up suddenly, allowing charged
particles to flow in and out . This evens
the charge and returns the cell to resting
state.
.

13. The strongest evidence of efficacy is for depression. Four of 6 phase II
clinical trials and one recent meta-analysis have shown that it reduces
depressive symptoms. The effect appears to be long-lasting and
possibly permanent.3
One trial reported 69% improvement in mean Hamilton Depression
Rating Scale (HDRS) scores after five sessions of active tDCS over 1.5
weeks, compared with 30% improvement in the sham group 4
Another showed improvement of 40.5%, compared to 10.4% in the
sham group, after 10 consecutive weekdays of treatment 5 The
improvements are lasting, and comparable to anti-depressant drugs
such as Prozac. They also set in sooner6.
A recent meta-analysis of 108 studies indicated that active tDCS
results in reduction of symptom severity of approximately 29% and
that the beneficial effects persist for at least a month.7
References:
PubMed.com ( http://www.ncbi.nlm.nih.gov/pubmed?term=tDCS
Kadosh et al., Dept. Experimental Psychology Oxford University,
“The Neuroethics of non-invasive brain stimulation”, Current Biology 2012 Feb 21;22(4):R108-
11.
Fregni et al, “ Transcranial direct current stimulation for the treatment of major depressive dsorder:
A summary of preclinical, clinical and translational findings” Psychology Medicine. 2012 Jan 12:1-
10. http://www.ncbi.nlm.nih.gov/pubmed/?term=Transcranial+direct+current+stimulation+for+the
+treatment+of+major+depressive+disorder%3A+A+summary+of+preclinical%2C+clinical+and+trans
lational+findings.+Fregni%2C+Boggio+et+al%2C+Psychol+Med.+2012+Jan+12%3A1-10.
4 Fregni F,et al “Treatment of major depression with transcranial direct current
stimulation.” Bipolar Disord 2006; 8:203-4.
http://www.ncbi.nlm.nih.gov/pubmed/?term=Treatment+of+major+depression+with+transcranial
+direct+current+stimulation.%E2%80%9D+Bipolar+Disord
5 Boggio et al “A randomized, double-blind clinical trial on the efficacy of cortical
direct current stimulation for the treatment of major depression.” Núcleo de Neurociências, Centro
de Ciências Biológicas e da Saúde, Universidade Presbiteriana Mackenzie, Sao Paulo, Brazil. nt J
Neuropsychopharmacol. 2008 Mar;11(2):249-54 boggio@usp.br
http://www.ncbi.nlm.nih.gov/pubmed/?term=Boggio+2008+tDCS+depression.
6 Rigonatti et al “Transcranial direct stimulation and fluoxetine for the treatment of
depression.” Eur Psychiatry 2008; 23:74-6.
http://www.ncbi.nlm.nih.gov/pubmed/?term=Transcranial+direct+stimulation+and+fluoxetine+for
+the+treatment+of+depression
7 Kalu et al “TRanscranial direct current stimulation in the treatment of major depression- a
meta-
Analysis” Psychol Med. 2012 Sep;42(9):1791-
http://www.ncbi.nlm.nih.gov/pubmed/?term=Kalu+tDCS
8 Shiozawa et al “Safety of repeated tDCS” The Laboratory of Neuromodulation, Dept of
Psychiatry,
Santa Casa Medical School Sao Paulo http://www.ncbi.nlm.nih.gov/pubmed/23303424
For a full list of studies relating to tDCS please see
http://www.ncbi.nlm.nih.gov/pubmed/?term=tDCS
DIY tDCS: http://www.diytdcs.com/
12
References - Depression

14. Neuroprime
tDCS treatment for depression
www.neuroprime-tdcs.com
01608 643922