Neuromodulation Service

A: The Neuromodulation Service (NMS) is a resource, housed in the Waisman Center, that provides access to non-invasive brain stimulation (NIBS) technologies. The NMS supports translational healthcare research by providing a platform for clinical trials and other research studies aimed at understanding and improving brain function. It facilitates the development of new therapeutic protocols and enhances the integration of NIBS techniques into clinical practice, ultimately improving patient outcomes. By providing a centralized resource for NIBS technologies and expertise, the NMS lowers cost barriers for researchers at the University of Wisconsin-Madison to incorporate NIBS in their studies.

A: Non-invasive brain stimulation (NIBS) is an umbrella term for technologies that allow us to alter brain activity without using implanted devices. NIBS provides a powerful set of tools to study the brain and can even be used to promote healthier brain activity. When combined with other types of therapy, NIBS can further enhance their effectiveness.

A: The NMS currently provides access to transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) services. See the sections below for more details on TMS and tDCS. NIBS is an actively developing field with many new technologies being researched and developed. As the NMS develops, we will continue to expand our services to offer additional forms of NIBS and even greater breadth of research tools.

A: Transcranial magnetic stimulation (TMS) is a technique for non-invasively activating neurons (brain cells) through the use of electromagnetic fields. A hand-held coil is placed on the participant’s head to deliver a brief pulse of energy. This energy activates the neurons under the TMS coil by making use of the natural signaling properties of the brain. TMS can be used as a tool for assessing different regions of the brain to understand their functions or for altering brain activity to improve health outcomes.

A: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that delivers a low electric current to the scalp through electrodes. This current changes the activity of neurons, either enhancing or inhibiting their activity in targeted areas depending on how the electrical current is delivered. tDCS is used for various applications, including answering questions about the function of targeted brain areas and the treatment of neurological and psychiatric conditions.

A: NIBS offers several potential benefits. Researchers are currently studying if NIBS can be used to improve cognitive function, enhanced motor skills, and provide therapeutic effects for conditions like depression, obsessive-compulsive disorder, and chronic pain. NIBS may also support healing after stroke and other brain injuries by promoting neuroplasticity and functional recovery. In addition to the use of NIBS as a means of clinical intervention, NIBS technologies offer powerful ways for researchers to study a variety of brain processes, advancing our understanding of how the brain works on a fundamental level.

A: NIBS is generally safe and well-tolerated. Possible side effects depend on the type of NIBS the individual is receiving.

• tDCS: Side effects of tDCS are minor and may include skin redness, itching, or tingling at the electrode site. Some individuals might experience headaches or sleepiness. Side effects are typically mild and transient.
• TMS: Minor side effects of TMS may be headache, muscle twitching during stimulation, and discomfort at the stimulation site. Individuals with a history of fainting during medical procedures may faint during TMS. In very rare cases, seizures have occurred during TMS. All TMS related seizures to date have resolved once stimulation stopped and have not been associated with any increased risk of subsequent seizures. Many side effects can be mitigated or prevented with the use of safety screening questionnaires, before the stimulation, and symptom monitoring during stimulation.

A: NIBS sensations depend on the type of stimulation the individual is receiving.

• tDCS: Participants may feel a mild tingling, itching, or a sensation similar to pins and needles on the scalp where the electrodes are placed. These sensations usually last only a few minutes and are not painful.
• TMS: Participants may feel a light tapping sensation on the scalp where TMS is being delivered and may hear a clicking noise. TMS near the face can produce facial muscle twitches and discomfort in some individuals. In many cases, the intensity of stimulation can be adjusted to the participant’s tolerance.

A: NIBS has been found to be safe in studies with adults and children. Individuals with implanted devices such as cardiac pacemakers, biostimulators, or intracranial electrodes should not receive some forms of NIBS. People with non-removable metal in the head or neck should not receive TMS.  Forms of NIBS are used with US Food and Drug Administration (FDA) approval for diagnoses such as depression, and research, including research in the NMS expands our understanding of applications in other diagnosis.  This research is performed under FDA, Institutional Review Board and Monitoring audits and regulation.