At least initially, most care is self-care with over-the-counter drugs and medical supplies from the drugstore. With the advent of the Internet consumers have access to more information about a given disease or condition than their doctors would have time to explain to them. When informed patients discuss health conditions with their doctors, they start from a level of knowledge that allows them to discuss problems without reviewing the basics. I’m a firm believer in empowered patients. I’ve always believed that knowledgeable patients benefit both themselves and their doctors.
Is there a downside to patient power? Sometimes consumers embrace fads and treatments of unknown or dubious merit. Case in point, some people are zapping their brains with electronic devices. Is this a good idea? Scientists don’t yet know the answer to that question.
At-home use of brain stimulation devices is picking up speed faster than scientists’ ability to determine how well it works.
Brain stimulation comes in many different forms, but they are all centered on the same idea: sending tiny zaps to specific parts of the brain to alter its activity. Some of its uses are well-established: transcranial magnetic stimulation is used in hospitals and clinics as a way to treat depression. Another version, deep brain stimulation, involves surgically implanting electrodes in the brain, and has been used for years to ease symptoms of Parkinson’s disease.
Some consumers are buying off-the-shelf brain stimulators for do-it-yourself treatments, but what are these and where to they come from?
Most brain stimulating techniques involve placing electrodes — conductors through which electricity travels — on certain parts of a person’s head. These electrodes send tiny electrical impulses through the skull to the brain.
Medical uses of brain stimulation typically take place in hospitals or doctors’ offices. But the use of at-home brain stimulation devices is flourishing among a group of enthusiasts, who say it enhances their mental state and gives them an edge, like on an upcoming exam or a project at work. Others credit it as a way to achieve deeper meditative states or mental clarity.
The at-home devices are available online and typically range in cost from as little as $40 to around $500. They are usually no bigger than a television remote or a smartphone; batteries, head caps and straps, saline and other accessories needed to send the weak pulses of electricity to the brain are sometimes sold separately.
Over-the-counter, at-home electronic brain stimulation is rising in popularity but is this a good idea?
“We are talking about injecting electricity into someone’s brain. Someone could get hurt,” he said. “We need to better understand what these tools can do including any unintended consequences they may have.”
The use of over-the-counter brain stimulators began picking up speed about a dozen years ago. Scientists think the technology ill-suited for at-home use, but the medical establishment has a long history of guarding its technology from leaving the clinic. Twenty years ago the U.S. Food and Drug Administration ignited controversy when it approved Claritin for over-the-counter sales. Yes, Claritin! Some physicians worried that allergy sufferers would self-medicate instead of seeing their doctors. Other physicians argued the move would harm patients by switching a drug covered by health insurance into an OTC one that had to be paid out-of-pocket. By the way, Claritin cost $80 to $85 a month back in 2001. When adjusted for inflation that price would be $136 to $144 a month today. Twenty-two years later I can buy a year’s supply of generic Claritin (Loratadine) for $12.99 on Amazon. I digress, back to brain zappers.
“They weren’t too pleased that individuals were essentially using the same technology as they were doing but doing it at home, so using similar devices to stimulate their own brains with low levels of electricity at home,” she said.
Electronic brain stimulation appears to aid memory and cognitive ability, but the sciences is still pretty new. There may be parameters that consumers don’t know about or understand. Or maybe doctors’ fears are as overblown as they were about Claritin.
Reinhart led a study, published in August in the journal Nature Neuroscience, that found that delivering small electric zaps to the brain appeared to boost memory in a group of older adults for at least one month. The study included 150 people ages 65 to 88 who did not have a diagnosed neurological disorder. Patients were asked to wear a cap embedded with electrodes for 20 minutes on four consecutive days. The type of stimulation was similar to transcranial direct current stimulation, but used a different type of electrical current.
Scientists may prefer patients use brain stimulation under medical supervision but with few doctors familiar with it and research studies difficult to participate in many patients will go it along or with online groups of others.
Transcranial direct current stimulation has gained traction online. The subreddit tDCS is dedicated to discussing the science, technology and use of brain stimulation devices. The group boasts more than 16,000 members.
But whether the at-home devices actually help improve people’s mental performance is up for debate, Reinhart said, noting that the public adoption of tDCS is happening faster than the accumulation of scientists’ knowledge about the method.
Direct brain stimulation may do nothing. It may create short-lived benefits or boost cognitive ability in one area at the expense of another. That is something that scientists will have to sort out while consumers try it on themselves. And that does not particularly bother me.