Spaulding Rehabilitation Hospital 3 articles published in JoVE Neuroscience The Combined Use of Transcranial Direct Current Stimulation and Robotic Therapy for the Upper Limb Marcus Yu Bin Pai1, Thais Tavares Terranova1, Marcel Simis1, Felipe Fregni2, Linamara Rizzo Battistella1 1Department of Physical Medicine and Rehabilitation, Instituto de Reabilitação Lucy Montoro, 2Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School The combined use of transcranial direct current stimulation and robotic therapy as an add-on for conventional rehabilitation therapy may result in improved therapeutic outcomes due to modulation of brain plasticity. In this article, we describe the combined methods used in our institute for improving motor performance after stroke. Medicine Home-Based Transcranial Direct Current Stimulation Device Development: An Updated Protocol Used at Home in Healthy Subjects and Fibromyalgia Patients Fabiana Carvalho1,2, Aline Patrícia Brietzke1,2, Assunta Gasparin1,2, Franciele Pereira dos Santos2,3, Rafael Vercelino4, Rafael Firmino Ballester2,3, Paulo Roberto Stefani Sanches5, Danton Pereira da Silva Jr5, Iraci L. S. Torres1,6, Felipe Fregni7,8, Wolnei Caumo1,2,9,10 1Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), 2Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), 3School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), 4Faculdade de Desenvolvimento do Rio Grande do Sul (FADERGS), Health and Wellness School Laureate International Universities, 5Biomedical Engineering Department, Hospital de Clínicas de Porto Alegre (HCPA), 6Pharmacology Department, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), 7Department of Physical Medicine and Rehabilitation, Harvard Medical School, 8Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, 9Pain and Palliative Care Service, Hospital de Clínicas de Porto Alegre (HCPA), 10Department of Surgery, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS) This study provides an updated home-based tDCS protocol that enables subjects to receive the beneficial effects of tDCS at home with an easy to use device with settings to control the use and dosage, enhancing the feasibility for long-term use at home. Medicine Technique and Considerations in the Use of 4x1 Ring High-definition Transcranial Direct Current Stimulation (HD-tDCS) Mauricio F. Villamar1,2, Magdalena Sarah Volz1,3, Marom Bikson4, Abhishek Datta1,4, Alexandre F. DaSilva*5, Felipe Fregni*1 1Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 2School of Medicine, Pontifical Catholic University of Ecuador, 3Charité University Medicine Berlin, 4The City College of The City University of New York, 5Headache & Orofacial Pain Effort (H.O.P.E.), Biologic & Materials Sciences, School of Dentistry, University of Michigan High-definition transcranial direct current stimulation (HD-tDCS), with its 4x1-ring montage, is a noninvasive brain stimulation technique that combines both the neuromodulatory effects of conventional tDCS with increased focality. This article provides a systematic demonstration of the use of 4x1 HD-tDCS, and the considerations needed for safe and effective stimulation.