Dawn Brazell | firstname.lastname@example.org | January 31, 2017
The premise is simple. More people might practice and benefit from meditation if it weren’t so hard to do.
That idea, paired with some wires and a 9-volt battery in the hands of neuroscience Ph.D. candidate Bashar Badran, turned into a research study published recently in the journal Brain Stimulation that is the first to look at using transcranial direct current stimulation, known as tDCS, to enhance meditation.
The pilot trial shows the use of tDCS actually could make meditating easier, demonstrating the feasibility and safety of using tDCS paired with a guided mindfulness meditation audio to help subjects achieve a calmer state. Badran calls his novel tDCS-enhanced meditation technique “e-meditation.”
It’s the perfect study for Badran, whose mentor, Mark George, M.D., pioneered the use of transcranial magnetic stimulation for the treatment of depression and remains one of the world’s leading researchers into brain stimulation techniques. Badran, who used two different mindfulness scales and mood rating scales on 15 participants in a double-blind study, found that feelings of calmness increased almost 2.5 times in the group receiving active tDCS-paired meditation compared to the placebo. Individuals receiving the sham stimulation had just a 5 percent increase in calmness rating.
“When you use e-meditation, your feeling of calmness is increased by almost 15 percent after only 20 minutes, so it’s almost a three-fold increase compared to the placebo, which is huge after just one session. We think if you do multiple sessions, the effects could be compounded.”
|Badran demonstrates how the electrodes are placed during tDCS with Caroline Summer, a MUSC research assistant and College of Charleston student.|
Another interesting impact is that a feeling of restlessness, a key emotion that derails many people who try to meditate, decreased twice as much for people receiving the higher tDCS dose compared to the placebo group. This decrease in restlessness could allow for e-meditation participants to get over the steep learning curve when first attempting to meditate.
“Some people come in, and they’re little amped. They’re shaky. They’re bouncing all over the walls. The restlessness scale is kind of a surrogate marker of calm,” he says. “The active e-meditation kind of really took that excitement and restlessness away. Overall, e-meditation had a really strong calming effect in these individuals.”
Badran says tDCS is a safe, low-risk form of noninvasive brain stimulation. Calling it e-meditation, Badran says the novel method involves pairing tDCS with a guided mindfulness meditation recording aimed to achieve a two goals: reducing the learning curve involved in practicing mindfulness meditation while simultaneously enhancing the acute health benefits of meditation. None of the study subjects had any experience with prior mindfulness-based interventions.
“We believe e-meditation could be a powerful tool for meditators and as an intervention that should be further explored in a population of subjects with neuropsychiatric disorders.”
One of the study participants was psychiatrist James Fox, who says he was interested in participating because of the advances in the field of brain stimulation and its potential to help clients with neuropsychiatric disorders.
“As a psychiatrist at MUSC, I’m interested in both mindfulness techniques and brain stimulation therapies in order to treat patients. Personally, I wanted to know what it felt like to have the tDCS and to see if I could notice an effect,” he says.
He could. “It tingled a little bit at first, but then was not very noticeable. It wasn’t at all painful. And it was exciting, like being a part of a science fiction novel.”
As part of the treatment, Fox was asked to listen to a recording while possibly receiving tDCS.
“The audio was soothing and relaxing. It lasted five minutes, instructing on the basics of meditation and focusing your mind and clearing your thoughts. It suggested treating your thoughts as clouds and allowing them to come and go without judgment and to pay attention to your body and breath.”
Fox says the meditation piece alone was calming and relaxing.
“I spend much of my day responding to issues that pop up and need my attention, and then trying to re-orient myself back to what I was doing. I’m constantly going over things in my mind to be sure I haven’t forgotten to something due to the many distractions I face,” he says. “Meditating really helped to refresh me and sharpen my mind again. I am not certain when I received the active tDCS or not, but I think the tDCS allowed me to better focus, and my mind did not drift as easily.”
That’s just what Badran wants to hear.
Long-term meditation practice induces changes in the cerebral macro-structure and functioning in the brain and produces health benefits, including decreased anxiety and depression, Badran says. Research shows that experienced meditators are able to turn down a specific part of their brain in the frontal lobe when they meditate compared to inexperienced meditators.
“I have tried meditating a lot before, and I know a lot of people who have tried and it didn’t really take because it was difficult,” Badran says. “We have a lot of intrusive thoughts that distract us.”
|Badran says meditation has been shown to improve physical, mental and social well-being as well as decrease stress, anxiety and depression.|
With tDCS, a small current runs from two electrodes that are placed on the head, creating a negative shift over the left frontal part of the brain and a positive shift on the right. Badran says this is important because when learning to meditate, part of the brain has increased activity, while another area gets dampened.
“We essentially are using the polarity of the electricity to modulate and tap into that network that is normally turned on or off in your meditative state. The frontal parts of the brain are associated with a lot of things: cognition, awareness, mood states, positive and negative affect. Meditation kind of turns up parts of these regions and, in other regions, turns them down.”
In deciding where to place the electrodes, Badran turned to a friend’s research that involved using tDCS to train soldiers to detect hidden and camouflaged objects. Vincent Clark, a neuroscientist at the University of New Mexico, demonstrated in 2011 that tDCS can be used to accelerate learning paradigms guided by changes in the underlying functional neurocircuitry. Clark placed an electrode over the right temple and another on the shoulder, finding people who received the tDCS-enhanced video training had two times better performance than people who got the placebo. “So we knew that the specific polarity and electrode placement there enhanced learning in a visual paradigm.”
Badran was curious about what would happen if he used tDCS to accelerate learning in one paradigm while simultaneously using the opposite polarity of the current to silence another part of the brain. Research suggests the electrode on the right side of the brain accelerates learning paradigms. On the left side, it is hypothesized it introduces this shift in frontal activity to temporarily silence the brain, he says.
This was a small, pilot study, and subjects weren’t followed to see how long the effects lasted, so more research is needed, he says. What is interesting, though, is that subjects were safely left alone in a room to e-meditate and were remotely monitored from a different room via web-cam, which means this could potentially be a treatment that patients could do on their own at home.
But should they?
Badran says it’s a hard question, and the field is divided into two camps. One group thinks it should be accessible for home use. The other says it always should be medically supervised. Badran falls somewhere in the middle, he says.
“I think it’s safe and people should be able to do it at home, but I think there needs to be more long-term research on it,” he says, adding that he can see the benefits of creating a home-based product to ease access of use. “There are a lot of products out there that are not evidenced-based, including a lot of devices. There’s a huge industry based purely on supplements that are not evidenced-based or regulated. So is this going to be one of those things?”
Dr. Mark George (left) with Dr. Baron Short in the brain stimulation laboratory at MUSC showing the controls for an implantable neurostimulator.
Badran says his goal is take a scientific approach and develop evidence-based guidelines so that brain stimulation devices can be used safely at home. “I think that’s really important. In order to really help as many people as possible, you need to have some trials that support that it’s safe and effective and that you can do it without supervision.”
MUSC has one of the best brain stimulation labs in the nation, he says. “Our group goes to conferences and give talks all over the world about these devices, and people believe in us because we are good scientists and good researchers who employ a really strict scientific method.”
There’s a wide range of potential for these devices in the future, from use by executives and students to augment learning, to use in inpatient settings to treat anxiety and other disorders. Badran says he wanted to do the e-meditation study because not everyone has hours to meditate, but 20 minutes is doable. Given how stimulated and stressed people are today, it’s hard to settle enough to get to a meditative state. “People who have never been able to get to a place where they saw any benefit from any mediation, try this one time and love it, and experience something they have never experienced before,” he says.
He admits there is irony in using technology to help people de-stress and unplug.
“We are talking about the centuries-old tradition of meditation. This is really the first time someone has introduced something to enhance and facilitate mediation, and it’s a little weird, but I think it’s also really cool. We are in the 21st century, and it’s definitely time for it. There are so many perceived health benefits of meditation that can become more accessible with this technology.”
The other upside to brain stimulation therapies is that they offer a non-pharmaceutical type of treatment. People should avoid using tDCS if they have open wounds at the sites of stimulation, metal in their head or a history of seizures. Otherwise, studies suggest it’s safe for use and e-meditation may make a mindfulness practice a possibility for someone who’s never been able to settle enough to attempt it.
“There are Buddhist monks who meditate their entire life. They’re so good at regulating their neuronal processes that studies show they can willfully turn off part of their brain that’s associated with all of this mental chatter. They can just instantly turn it off. Ninety-nine percent of people are not monks. They are just like you and me. And I think this can help.”