Fregni, the Harvard researcher who was lead author on both studies, says tDCS would offer one huge advantage when compared with drug treatments. Drugs can potentially expose the entire brain and body to chemical changes, while tDCS would affect only one neighborhood of the brain. “There are large advantages because you are targeting a problem,” he said. Of course, tDCS still has yet to prove itself in a large study.
How, I ask him, would such a low-tech machine ever make it to the market? Who would pay the exorbitant bill required to secure FDA approval for the pocket-size brain zapper, especially when anyone can rip off the design?
“It’s a big concern, the future of this technique,” Fregni agrees, sighing. Big Pharma, he notes, already has a tried-and-true method for generating profits: a company can change one molecule of an existing drug, make up a new name for it, splash advertisements on TV, and resell it at a much higher price “In a market like that it’s hard to compete,” he says.
Fregni notes that the machine has a greater chance of catching on outside the United States. In Germany, for instance, two companies — Schneider Electronic and Eldith — already sell tDCS machines for use in labs. These gizmos cost a bafflingly large amount of money: the equivalent of thousands of US dollars. Apparently, it pays to sell machines to researchers. But what about ordinary people?
Fregni believes that tDCS might be particularly suited to the needs of developing nations, where those who suffer from depression have little access to meds. Last year, he and some of his colleagues wrote a letter to the British Journal of Psychiatry suggesting that tDCS machines — which could cost under $100 and be rigged up in local factories — might be a good fit for poor countries. Indeed, a group in Brazil is now developing such a low-cost machine.
Perminder S. Sachdev, a neuropsychologist at the University of New South Wales, fired back a rebuttal in the same journal: “Depressed patients in the developing world should be dissuaded from unplugging their car batteries and clamping them on their foreheads.” But a few months later, the outraged Sachdev had apparently become a convert. He contacted Fregni asking for more information about tDCS — it seemed that he, too, wanted to study tDCS as a treatment for depression.
Eric Wassermann, chief of brain stimulation in the Office of the Clinical Director at NIH’s National Institute of Neurological Disorders and Stroke, believes that if we are ever to have a brain-pod in the United States, it would likely be tested and developed by the military first. But he doesn’t rule out the chance that a private company would bankroll tDCS if it continues to perform in the lab. “It is unlikely that any [company] would do this unless they were guaranteed a market share, and the only way they could be guaranteed a market share would be if they had a patent on some important part of the process. I think we know so little about it at this point that there may be patent-able parts.”
However, Wassermann is not eager to put this device into the hands of consumers; he’s concerned about the ethical problems it poses. “I would not be in favor of this being an iPod. Not yet. Not until the issues of safety and fairness have been resolved.”