Flavio Frohlich
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2/28/2018

Things you wish you had known before your first tDCS/tACS study

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As you may be aware of, scientists enjoy controversies. After all, spirited discussions are often the source of innovation, intellectual advances, and inspiration. Also, let's face it, sometimes they are not. In any case, recent papers have started to seriously question some of the assumptions that build the foundation of many tDCS/tACS studies. Some of the objections are likely appropriate, others I would disagree with (this is material for another post). One thing that is clear to me is that the field has grown so fast and attracted so many researchers with little background in using brain stimulation, or even neuroscience, that I often see studies that are unfortunately tainted by some newbie mistakes. So here is my mission: let's talk about some of these challenges to improve the quality of our studies.
  • Blinding: Studies need to be double-blind or triple-blind or whatever you want to call it. In any case, neither participants not researchers that interact with researchers should know the stimulation condition. The placebo effect is an incredibly powerful force you do not want to mess with. Also, you need to make sure that "the blind worked." You need to ask both your research participants and your study personnel what study condition they guess they experienced (and why). This is important because you do feel tDCS/tACS! Carefully chosen "active sham" palcebo stimulation can help. If your device cannot do that, then I see you over at my company Pulvinar Neuro, which sells the device we developed to address this issue.
  • Be prepared to fight very hard to get a negative result published. Be honest, pre-define your outcomes (in the US this is now required by federal code, see clinicaltrials.gov), admit to yourself that your study was negative, and do not do some magic statistics to claim some really weird four-way interaction. It will be frustratingly hard because editors fear it will reduce their journal's impact factor, but please do so. Otherwise the "file drawer" effect, which could be also called "biased editor", effect will introduce such a large publication bias that can sink an entire promising field!
  • Have the appropriate control conditions. If you do tACS, I strongly recommend a control frequency in addition to the placebo condition such that you can make a statement about a frequency-specific effect, which is at the heart of how we think tACS works. If you do tDCS, make sure to include an anodal and cathodal group.
  • Make sure to include some type of target engagement measurement (EEG, fMRI, etc). Any behavioral findings without some evidence of changes in neuronal activity (even if quite indirect, still way better than nothing) is hard to interpret.
  • Run your electric field simulations before you do your study to know where your electric current goes. There are now a number of great tools available, both free and commercial. Use at least one of them! BTW, NIMH will not consider tDCS/tACS grants anymore if they do not include such modeling.
Now do not get me wrong, I am as "guilty" as anyone else. Our field has rapidly developed and we all have published papers that do not quite match these standards. However, I encourage you to think about these things, especially if you are new to the field. We will discuss all this and much more in our May 21st tACS/tDCS workshop at UNC as part of the Carolina Neurostimulation Conference. I hope to see you there!

Take care,

Flavio

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2/27/2018

Reason for Being

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As some you may know, I love to steal ideas from the business world and see how they could be applied to my research group. We had a long meeting for planning our epic brain stimulation conference in May, after which I decided to mix things up and start a conversation about a near-philosophical question: "What is our reason for being (as a research group)?" The conversation that ensued was truly inspiring. The "reason for being" is often also called the core purpose (in the language of Collins and Porras) and is defined as something which cannot be reached within anyone's lifetime. It is not to be confused with strategy or goals of an organization.

The reason for being of our Carolina Center for Neurostimulation is to develop innovative treatments that heal patients with CNS disease.

I am sure you pick up on the not-so-subtle distinction to how today's medicine is mostly turning patients into patients with chronic illnesses that require lifelong medication treatment. Our reason for existence is to develop treatments that surpass current (pharmacological) treatments and heal patients by restoring brain function and structure. Tough challenge. YES! Solvable in the next few years? NO! A core purpose that motivates us to work extra hard and smart. YES!

What is your organizations reason for being?

Take care.

Yours,

Flavio

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2/26/2018

Innovation

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Where does innovation come from in academic science labs? How do research projects become innovative? I find the answer to these questions not as trivial as it might seem at first glance. As the principal investigator (PI) of a group of about 20 scientists in training (mostly graduate students and postdocs), these are key questions for me. After almost seven years in my job as faculty at UNC, many of my original (crazy back then) ideas have transformed into solid research programs (e.g. use of tACS in clinical applications, mechanism of action of tACS). Thus, it is particularly important for us not get stuck with these ideas and concepts but to aggressively innovate, and find and explore the next frontiers in addition to these established lines of research. Here is how I think about the required innovation process.

My experience and expertise should allow me to generate new ideas (on most days I think I can succeed in this task). Inspiration comes from our ongoing work, comments and feedback by peers through grant review, paper reviews, questions when I give talks etc. Also random thoughts at random moments are not to be underestimated! I look at these ideas as seeds that ultimately will have to be grown into trees. My responsibility as the PI is to provide the resources to grow the tree, but the responsibility - I think - of the actual process should be in the hands of a graduate student or postdoc. Growing the tree from a seed (of innovation) requires a lot of hard work at the bench, intense literature study, and uncountable moments of thought and discussion. This is an ideal opportunity for my trainees to take on an important leadership role early on. As a mentor, I am focused on guiding the process, providing feedback, and creating a constructive and supportive environment. To take this one level further, in an ideal world trainees are inspired, creative, and passionate about science - quite likely some truly innovative ideas originate from them. Now that is paradise! I am privileged to have experienced these moments in my role as the PI of the Frohlich Lab and the director of the Carolina Center for Neurostimulation.


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2/19/2018

Registration is open!

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I am thrilled to announce that registration is now open for our Carolina Neurostimulation Conference (May 21-23). We have an amazing speaker lineup. We are pleased to offer a hands-on tDCS/tACS course on May 21 (separate registration). 

We are committed to an inclusive and diverse meeting. To ensure that a broad range of academic participants can join us, we have set the registration fee (ridiculously!) low. Thanks to multiple generous sponsors, we are able to offer registration for $95 to trainees and for $165 to everyone else. We have designed this meeting to address several urgent needs that we feel the community has:
  • Diverse and inclusive meeting, including representation of women scientists.
  • Meeting in the South East of the US, where few meetings take place.
  • Integrated perspective that combines the basic science with the clinical applications of brain stimulation.
  • Longer talks that enable in-depth presentation of material (no rushing through slides in 20 minutes!).
Please do not hesitate to ask me any question you may have about this meeting. We are looking forward to having you for the meeting in May.

Take care,

Flavio

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