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Foc.us
Alex SimonBiotech Journal Club
June 12th, 2014
Electrotherapy Began 2000 Years Ago
• Torpedo Electric Fish (Romans)– Headache and Epilepsy Relief
• Aldini (1804)– First in modern era to treat mental
disorders with weak direct current
• Electroconvulsive Therapy discovered (1930s)– tDCS (transcranial Direct Current
Stimulation) falls out of favor
• A resurgence of interest in tDCS (2000s)– Noninvasive, well-tolerated,
inexpensiveStagg and Nitsche, 2011
Foc.us is Based on Transcranial Direct Current Stimulation (tDCS)
Paulus et al., 2013
tDCS Yields Long Lasting Effects
Stagg and Nitsche, 2011
Anodal Stimulation
• Strength of current is also important• Iterative tDCS sessions can increase
duration of excitability
tDCS Modulates Neuronal Excitability• Anode vs. Cathode• Varies from Transcranial Magnetic Stimulation
(TMS)
www.gizmag.com
Anodal Stimulation
Mechanisms of LTP for Long Term Changes with Anodal Stimulation
• Increases cAMP levels– 2nd messenger, leads
to transcription of synaptic machinery via CREB
• NMDA receptor dependent
• Increases Intracellular Ca++
Graupner and Brunel, 2010
What disease models has tDCS been tried in?
• Depression
Rigonatti et al., 2008
tDCS Has Many Potential Applications
• Parkinson's disease• Tinnitus • Amblyopia • Fibromyalgia• Post-stroke motor deficits
• Anxiety Disorders• Schizophrenia• Addiction
Full Summary of tDCS Studieshttp://bit.ly/1kjXZW2
What about cognition?
Anodal tDCS Improves Cognitive Function (Working Memory)
(p=.004)
Fregni et al., 2005
Cognitive Enhancement May Come at a Cost
Learning of the Task (Acquisition)
Reaction time of Learned Task (Automaticity)
Iuculano and Kadosh, 2013
Who started Foc.us?
• Michael Oxley– Not a scientist
• Grown out of a DIY community
The First Commercially Available tDCS Device
• $249• iOS
Integration via Bluetooth
• Uses established current/electrode parameters
Warnings by scientists• “Meddling with the tDCS dose is potentially as dangerous as tampering with
a drug’s chemical composition” – Nature, 2013
• Side Effects: – Burning Skin, Phosphenes, Itching, Headache, Nausea, Fatigue
• Long term effects?
• Stimulation protocols are very nuanced– Duration, Anodal/Cathodal, Current Intensity, Location, Handedness, Sweat/Hair,
Interactions with Extant Treatment
• Is Foc.us up to combating these health challenges, and potential FDA regulations?
tDCS Competitors
• Halo Headband• PhDs, Ex-CEOs, Google,
Facebook• Andreessen Horowitz
SoftTech VC: 1.5M Seed Round, May 2014
• No physical product yet
Discussion Points
• Where’s the regulation?• Do business owners have a responsibility for
safety or efficacy?• What are similar cognitive enhancing markets
that could avoid FDA regulations?• What other ‘homebrew’ technologies could
be commercialized? How?
