It’s a question of evidence, ethics, cost and hope.
PETER SIMPSON-YOUNG IS TORN. The Sydney-based
technologist has been contacted by a father desperate
to find a solution to his daughter’s depression. She’s in
her early twenties and has run the gamut of medication
and psychotherapy but is still suffering.
“SHOULD SHE TRY brain stimulation at home?” the
dad asked. He’s talking about transcranial direct
current stimulation (tDCS), the passing of a small
electric current through the brain by a device worn on
the head, something that’s been racking up evidence
points as a treatment for depression, early dementia
and even stroke.
It’s a technology that has also, in recent years, been
well and truly democratised. Anybody can pick up a
model such as the Brain Driver, Focus V3 or the snappy
Halo Sport online for around US$400.
Why then is Simpson-Young, who has a science
degree and a Masters in Health Technology Innovation
from the University of Sydney, wavering on whether to
recommend one to the young woman?
“I’ve used all of the devices, I think, at least all the
types of devices. I’m a technologist. They’re all shit.
Like, it’s the 21st century, yet tDCS is glorified ninevolt
batteries hooked up to dish sponges connected
to elastic bands on our heads,” says the side-burned,
youthful Simpson-Young over Skype.
“We are now at a position where the evidence is
ahead of the technology. No-one has made the product
that can deliver on the evidence.”
The precise state of that evidence and technology
is critical information, not just for the worried dad, but
for the sizeable bunch of people wondering if sending
current through their cranium is what it is cracked
up to be; the market for these devices and related
neurotech is tipped to pass US$3 billion by 2020.
All in all, it’s a very mixed bag.
In June, a pilot study led by Colleen Loo from
Sydney’s Black Dog Institute found depression got
significantly better in 34 patients using tDCS at home.
And in May, research led by Robert Reinhart at Boston
University in the US found that stimulating the noggins
of a group of adults over 60 gave them, briefly, the
short-term memory of 20-year-olds.
Back in December, a study of people who lost their
speech after a stroke found those who got tDCS had
more than double the improvement of controls who
didn’t get their brains tickled.
But a 2018 review concluded tDCS had only modest
and sometimes negative effects in depression. And in
2016, Dutch and German researchers testing the Focus
tDCS device on healthy volunteers found their shortterm
memory actually got worse.
Which is a lot of noise to cut through.
To help find the signal, I went to see Paul Fitzgerald,
a Professor of Psychiatry at Monash University in
Melbourne. He is also director of the Epworth Centre
for Innovation in Mental Health, which has digs in
an anonymous, glass-fronted cube of a building in
Melbourne’s leafy Camberwell, where I visit on a
drizzly winter day.
Fitzgerald is tallish, neatly groomed and serious,
speaking with the just discernible tension of someone
who has a lot on his plate. He is admirably patient as
I fire off my first question: “how do these things
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