Question
What does an occupational therapist need to know about noninvasive brain stimulation?
Answer
If you want to administer brain stimulation within the scope of your clinical practice, there is not any kind of additional consent needed from the patient. What you do need is you need to obtain a doctor's order to use this. If you are performing brain stimulation in a research setting (which is where the majority of my experience is), test subjects obviously have to consent to be in the study. You have to be very clear with them about what brain stimulation is, what side effects they might experience, what benefits they may or may not get, and what the potential consequences are.
No, you do not have to shave the subject's head. Interestingly, there is a lot of evidence suggesting that more of the current coming from the electrodes gets into the brain if you have hair, because hairs produce natural oils, which serve as a conductor for the current. If someone is bald, they have rougher skin with less natural oils, and it makes it more difficult for the current to get into the brain. You can put the electrode right over their hair.
There is not a certification necessarily in administering tDCS and TMS. I can tell you that Harvard has a center for noninvasive brain stimulation where I believe they offer a two-day-long course. They definitely have a course on both TMS and tDCS, depending on which one you are interested in. MUSC has just opened a center for noninvasive brain stimulation. I think "neuromodulation" is what they call it. They are having their first training sessions in March of next year where they will provide training on TMS and tDCS as well. Those are the two that I know of.
