1. A SYSTEM AND DEVICE FOR FOCAL tDCS: HIGH–DEFINITION(HD) tDCS Abhishek Datta Jeff Borckardt, Mark George, Mar Cortes, Dylan Edwards, Felipe Fregni, Eric Wassermann, Marom Bikson Neural Engineering Laboratory - Department of Biomedical Engineering The City College of New York of CUNY Neuromodulation Laboratory, Spaulding Rehabilatation Hospital Harvard Medical School

2. -application of currents delivered through the scalp to modulate brain activity. TRANSCRANIAL DIRECT CURRENT STIMULATION (tDCS) -number of disorders, rehabilatation and cognitive enhancement -safe,easy to apply, CHEAP!

3. SPATIAL TARGETING Brain Stimulation Electrodes Current flow and brain modulation Conventional Sponge-based Transcranial DC Stimulation

4. SPATIAL TARGETING Brain Stimulation Electrodes Current flow and brain modulation High-Definition (HD) Transcranial DC Stimulation Ring Configuration

5. High-definition (HD) Transcanial (4x1 Ring) Conventional Transcanial (large pad) FEM ANALYSIS OF TRANSCRANIAL ELECTROTHERAPY FOCALITY

6. CONVENTIONAL tDCS

7. Min Max Electric field 1 mA Datta et al., 2009 CONVENTIONAL tDCS

8. HIGH DEFINITION (HD)- tDCS

9. Min Max Electric field 2 mA HIGH DEFINITION (HD)- tDCS Datta et al., 2009

10. HD tDCS – 4x1 Hardware DevelopmentClinical Trials NIH-NINDS Eric Wassermann, Egas Caparelli Dáquer MUSC Mark George Jeff Borckardt Burke Rehabilitation Dylan Edwards Mar Cortes Harvard (Spaulding) Felipe Fregni ……. Soterix Medical

11. PILOT CLINICAL STUDY 1: EXPERIMENTAL PAIN (MUSC) Setup

12. PILOT CLINICAL STUDY 1: EXPERIMENTAL PAIN (MUSC) Borckardt et al., under review Analgesic effects in an experimental pain model…… Significant effect for sensory thresholds.

13. Edwards et al., under review Targeting Validation PILOT CLINICAL STUDY 2: COMBINED TES & MODELING (BURKE REHABILATATION) Transcranial Electrical Stimulation (TES) – short high-intensity pulse that triggers motor response (MEP)

14. ANODE:C3 CATHODE:FC5,FC1,CP5,CP1 PILOT CLINICAL STUDY 2: COMBINED TES & MODELING (BURKE REHABILATATION) ANODE:F3 CATHODE:AF7,AFz,FC5,FC1 ANODE:P3 CATHODE:CP5,CP1,PO7,POz Peak 0 Electric field/Current density 33% 66% Edwards et al., under review

15. -Retains advantages of conventional therapy ADVANTAGE OF HD CONFIGURATIONS: Other configurations can be used: (4 X 4, 5X2…) based on application -Cortical regions can be selectively targeted using a HD system. -Customizable (individualized therapy) Procedures, implants… Skull Defects / TBI Stroke