Not in the Box:

The SpeakWisdom Guide to Using the

foc.us tDCS Headset
By: Brent Williams, PhD, brent@speakwisdom.com
Copyright 2013, 2014, All Rights Reserved


(The foc.us headset resting on its accessory stand.)
Important Notes

1. This is version 2.1 of this guide, current as of 1/1/2014
2. This guide is intended to help you successfully use the foc.us tDCS headset out of the box. This
is a living document and will be updated as new information or corrections become available.
The document version number and date will be incremented as it is updated.
3. This document is provided as information only. I do not prescribe or recommend tDCS
treatments. You are responsible for any actions you take as result of reading this document and
using the foc.us headset (or any other tDCS device).
4. As of this writing, the iOS app for the foc.us headset does not appear to function correctly with
iOS 7. When a new version is released an iOS App section will be added to this guide.

This document is divided into four sections:

Section One: Quick Start
Section Two: Application
Section Three: Safety
Section Four: Using Wire Electrodes
Introduction

Welcome to the brave new world of transcranial direct current stimulation (tDCS). tDCS is an amazing,
simple, and apparently safe technology that is surprising the medical community, researchers, and
laymen alike by all that it can do. tDCS is well researched and has been written about in scientific
literature for decades. See www.pubmed.com (search tDCS) for many examples. Whether you are
seeking to improve a condition like depression or chronic pain or simply seeking to improve your ability
to memorize or learn a new skill, there are already published studies indicating positive effects from
tDCS.
For more details on the basics of tDCS, please see the articles on my blog, www.speakwisdom.com. I
also suggest www.diytdcs.com and www.transcranialbrainstimulation.com.
tDCS is not yet well known as it has, until recently, only been available to researchers via expensive
commercial tDCS equipment or the curious (the do-it-yourself community), building their own tDCS
devices. In the last year, a small number of consumer oriented tDCS devices have begun to appear in
the marketplace. The foc.us headset represents the most innovative, sophisticated, and flexible of the
affordable new tDCS devices to this point. While marketed as a gamer accessory (probably to limit
FDA flack), this headset offers great potential to those seeking a very versatile tDCS device.
The foc.us headset comes preconfigured to deliver stimulation to the prefrontal cortex of the brain via a
conservative 0.8 milliamp (mA) 10 minute duration tDCS session. Researchers use up to 2 mA and 30
minutes per session.

Section One: QUICK START

Its like unwrapping a present! I know you want to slap the foc.us headset on your head and experience
instant gratification but hold on! There are some things to do first. Please take the time to read and
follow the steps below in order to have the best chance at a satisfying tDCS experience.

Some applications of tDCS can cause improvement after the first use (learning, memory, game playing),
others require multiple sessions (days) and an accumulated effect (treating depression for example). So
let your expectations be realistic take a deep breath and go for the long term benefits that you can
realize with tDCS.

1. Lets start at the beginning! Unpacking!

(The foc.us headset, case, instructions, etc.)

The foc.us headset arrives in an attractive and professionally prepared box. Inside is a travel and storage
case containing the headset, sponges, USB charging cord, a small bottle for water, instructions, and
foc.us stickers (ala Apple.)
2. Charge the Headset
Before you start fiddling, I suggest a good charge of the headset. Just plug the USB charger cord into the
bottom of the headset and some convenient USB ac-adapter (or PC) and give it a couple of hours. While
charging, the foc.us logo on the back of the headset glows GREEN. When charging is complete, the light
turns off. Make sure the switch on the bottom is set to W for charging (or when the headset is not
being used). Oddly the headset switch positions are O for on and W for off. I get O for on, but
what does W stand for? Normal full charge time seems to be about two hours.

(Left to right: Connector for wire electrodes, on-off switch, USB charge connector)



3. Electrode Position
The comfortable and light headset has a fixed position for its electrodes, placing them on the forehead
and upper forehead. The position selected by foc.us will be of interest to a large audience. Why? It
happens to correspond nicely to an accepted location for treatment of depression (yes, there are others)
and the position described in various studies for learning, memory, and gaming enhancement. Electrode
placements not addressed by the headset itself are handled with the wire electrodes in the foc.us
accessory kit. The accessory kit is needed for treating chronic pain and for savant learning as well as a
number of other possible tDCS scenarios.

(Correct positioning of foc.us headset. Lower sponges above the eyebrows, centered.)
For the slightly technical, you will want to know that when wearing the headset, the left electrodes
(sponges) are the ANODE and the right are the CATHODE. Two electrodes on each side? Think of it as a
way to have one larger sponge on each side covering more of the frontal lobe area.
4. Electrode Sponge Wetness
To avoid irritation, youll want to make sure your foc.us electrode sponges are wet (not dripping) before
inserting them into the sockets on the headset. When wearing the headset, make sure the sponges are
flat against your forehead and upper forehead. (No hair or other obstructions under the sponges.)
I suggest storing the wet sponges in a small, sealed plastic or glass container when not in use. Dont let
them dry out! They will shrink to a tiny size and never return to normal, even when re-wetted. Further,
you should occasionally wash the sponges with non-irritating soap and rinse them thoroughly (dont
want anything weird growing on them!)
Should I use saline water or not? Some tDCS researchers wet their sponges with just tap water (it has
enough impurities to provide enhanced conductivity) while others use saline water (add a teaspoon of
salt to a water-bottle of water). Use whichever works best for you. I prefer just tap water its not as
messy and is less likely to corrode things.

(It is normal for the copper plates in the foc.us headset to show some green oxidation with use it does
not interfere with headset operation. Some of the oxidation will transfer to the sponges. Always use
that side against the copper plates to avoid turning your forehead green!)
5. Turning the foc.us Headset On
Proper orientation of the headset can be seen in the pictures included in this guide. Note: With the
headset on your head, the slide-switch and connectors will be facing DOWN.
In order to operate, the slide switch on the bottom of the headset must be switched to the O position.
To conserve battery, return the switch to the W position when not in use.
The main operating control is a touch button on the back of the headset. It allows setting treatment
type, current level, and starting and stopping treatment sessions. The default current level is 0.8 mA and
the default session length is 10 minutes.
NOTE: You will need to practice with the touch-button to get the hang of it. I find FULLY covering
the button indentation with my thumb or forefinger to be the most effective. If you only partially cover
the button it may not recognize your touch. Practice makes perfect.
Place the headset on your head as shown.
Now touch and hold the touch-button for about two seconds to put the headset into READY state.
You will feel the headset vibrate (and the focus logo will blink blue)
To start a tDCS session, touch and hold the touch-button again for about half a second. You will feel
three long buzzes and two short ones. The tDCS session now begins with a brief ramp-up of current to
0.8 mA. The foc.us logo will glow blue while the session is in progress. The session continues for 10
minutes at which time current will ramp down and the session ends (and the blue light goes off). NOTE:
There is no buzz or other indication when the session ends. If you are wearing the headset you wont
see the blue light go off either.
If you feel the session end (tingling stops), you can touch the touch-button for one second to cause
the session to repeat. If you wait too long, the headset will leave READY state and you will need to
start with the two-second touch (above) to start a tDCS session again.
6. What Will I Feel?
During a tDCS session, most users feel a slight tingling in the area of the sponges. As you become
accustomed to tDCS, you may eventually not even notice that feeling. NOTE: If the area around the
sponges is painful, you may not have the sponges flat against your skin or the sponges are too dry.
Check both and try again. Dont continue a painful tDCS session you may be irritating or burning your
skin. Stop the session and determine why pain is occurring. Again, a slight tingling is normal.
7. How to Stop a tDCS Session
If a tDCS session is in progress and you wish to stop it, simply touch the touch-button. Current will drop
to zero immediately and because of this you may experience a harmless phosphene a brief flash of
light in your eyes.
Dont yank the headset off of your head while a tDCS session is underway. The inverter circuitry of the
foc.us headset allows voltage to rise as high as 60 volts (according to the specs) to overcome resistance
between the anode and cathode. I measured 65 volts between the electrodes with no load (head) in
place. Dangerous? No, since current is always limited to 2 mA. But the charge can feel uncomfortable
(sting or feel like a static shock) if you pull the headset off while a session is in progress.
8. Maintenance
When not using the foc.us headset, make sure the slide switch is in the W position (it needs to be in
this position for charging, too.) My experience is that the foc.us headset can do many 10 minute tDCS
sessions on a single charge. Again, full charge time is about 2 hours.
Store your wet sponges in a sealed plastic or glass container. Keep them damp. Clean them periodically
with non-irritating soap (and water). The sponges should last a very long time.
9. Viewing Setup of the foc.us Headset
Your foc.us headset should arrive ready to provide a constant current, 0.8 mA tDCS session. If you
want to verify the settings of your headset do the following:
1. Set the slide switch to the O position
2. Touch the touch-button for two-seconds to put the headset in READY state
3. Now tap the touch-button THREE times about second between each tap
The headset will now blink out its current status. What you should see is the foc.us logo glow blue for
about five seconds (indicating it is set to provide constant current), followed by the blue logo going
very dim for about one second and then the logo going off (indicating it is set to 0.8 mA current
delivery). The blue logo will then blink about once every five seconds indicating it has returned to
READY state. Once back to READY state, you can tap the touch-button again (3 times) to repeat the
display.
If you see anything but the above, your headset is configured in some other way, in which case I suggest
you complete the steps below to make sure your headset is set up correctly.
10. Setup of the foc.us Headset
If you have glanced through the documentation provided with the foc.us headset, you may know that it
can be set to deliver current in four different modes and at four different current levels. Beginners
should stick with Constant Current, 0.8 mA. Only with experience and study of tDCS montages should
you move away from this setting.
Read Carefully, Setup can be Confusing
The blinking from the headset that is part of the setup process can be confusing. If you get lost, dont
feel bad, we have all been there. Just switch the headset off (W) and start over. After doing setup on
the headset a few times, you will get the hang of it.
1. Set the slide switch to the O position
2. Touch the touch-button for two- seconds to put the headset in READY state
3. Now tap the touch-button TWO times about second between each tap
4. The foc.us blue logo will start blinking the possible CURRENT settings. There are four that
appear in the order shown below. When you see the Constant Current indication, tap the
touch-button ONCE to select it.
a. Sine Wave logo brightness gradually rises and falls to off for five seconds (skip this
one)
b. Constant Current logo stays bright for five seconds (TAP NOW)
c. Pulsed Current with Offset logo brightness gradually rises and falls but never goes
completely off (skip this one)
d. Random Noise logo brightness changes erratically (skip this one)
5. After selecting current mode, you are presented with an opportunity to set the current
level. The logo will start very dim and then quickly move to a brighter and brighter display
to indicate each for four possible current settings.
a. Very dim indicates 0.8 mA (TAP NOW)
b. A bit brighter indicates 1.2 mA (or TAP NOW)
c. Even brighter indicates 1.5 mA (or ADVANCED USERS TAP NOW)
d. Brightest indicates 2.0 mA (skip this only works with accessory kit)
6. Thats it! The logo should return to blinking about once every five seconds (READY).
7. NOTE: There is no button control of session TIME. That is fixed at 10 minutes. The iOS app
(and Android) will allow setting session time when released.
8. The headset will remember your settings.
SPECIAL NOTE: If you received one of the first batch of foc.us tDCS headsets (early summer 2013) the
headsets have a defect that prevents them from pairing with BlueTooth devices, your headset has
another defect it wont remember your settings if you switch it off (W). It always returns to Constant
Current, 0.8 mA. If you want any other setting, you will have to set it each time you turn the headset on.
Foc.us has already provided a free replacement headset (that works correctly) to everyone who was
shipped a headset from the first batch.
Yea! Youve Got It! You Can Now Begin to Tap the Power of tDCS!
Section Two: Application

So now you have a good idea of how to operate the foc.us headset. So what are the applications and
possible results?
The foc.us headset stimulates the pre-frontal cortex of the brain. It stimulates a broad area (as do most
tDCS devices) and so has overlapping effects on the brain. Below are some possible applications of the
standard foc.us headset without the accessory kit.
Examples are general tDCS treatments cited in studies available at www.pubmed.gov and other web
sites.
Enhanced learning, enhanced memory: 1.2 or 1.5 mA, 20 minutes max per day. Procedure: Start a tDCS
session. Once the session has been in progress for about five minutes, begin study or memorizing.
Continue enhanced study or memorization for up to two hours after the tDCS session has completed.
Enhanced Ability at Game Playing: 0.8 or 1.2 mA, 20 minutes max per day two or three times per week.
Procedure: Start a tDCS session before beginning game play. Enhanced performance may persist for an
hour or two after the tDCS session ends.
Treating Depression, enhanced feeling of wellbeing: 1.2 or 1.5 mA, 20 minutes max per day, 5 days per
week for at least 4 weeks. Procedure: Relief from depression takes repeated tDCS sessions typically for
a month (sometimes two.) Its common for a depressed person to feel some relief after 4 or 5 tDCS
sessions. Once full relief is achieved, occasional retreatment can occur as needed if symptoms start to
return. Retreatment may be daily tDCS for up to five days.
IMPORTANT: Your mileage may vary! If you feel any ill effects from tDCS STOP immediately.
Conduct research or contact a medical professional to learn what you need to change before
attempting another tDCS session.
Section Three: Safety

tDCS has been in use for many years and in all that time, there has never been a reported serious safety
incident. On rare occasions, a user has reported excessive skin irritation. Thats it. Wow safer than
Aspirin! One of the reasons tDCS is so safe is that practitioners and users follow a set of guidelines
designed to keep tDCS safe.
Before using any tDCS device, you should agree to ALL of the following guidelines:

1. I will, if appropriate, seek out a medical professional for tDCS advice, treatments and follow-up.
2. If I have cranial scar tissue, an implant, or other unusual medical condition, I will seek clearance from
my doctor before using tDCS. If I have a seizure disorder I will refrain from using tDCS or use it only
under direct supervision of qualified medical personnel.
3. I will not exceed 30 minutes in a tDCS session nor more than one tDCS session per day. This is the
normal maximum used in tDCS research. I will use the buddy system and never proceed with a tDCS
session without someone else present who is familiar with the shutdown process for my tDCS device
or who can at least remove electrodes and summon additional help should that be necessary.
4. I will use some means to verify the current level being produced by my tDCS device or use a tDCS
device that has built-in current control. I will never exceed the 2 mA limit used by tDCS researchers.
5. I will use electrode placements that have been studied and published by respected researchers and
not simply guess or experiment with electrode placement. I will do my best to stay abreast of tDCS
research and developments.
6. If I detect any undesirable effect from tDCS, I will immediately cease use until the cause is clearly
understood and corrected.
7. I will not experiment on friends, family, associates, or others. It is up to each individual to read,
research, and understand the risks, benefits, and limitations of tDCS and make their own decision about
its appropriateness to their situation and if appropriate, in consultation with a medical professional. I
will never use tDCS on children or animals.
8. I understand that, with regard to tDCS and any actions I might take, I am responsible for my own well-
being and above all else, safety and wise decisions will be my primary concerns.

Section Four: Using Wire Electrodes

The built-on electrodes place the anode above the left eye and high on the left forehead (two
sponges.) The cathode is in the same positions but on the right side. These positions, while perhaps not
ideal in the eyes of some are probably close enough to published locations for the basic montages
described earlier in this document. For depression, some have a preference for moving the cathode off
to the right shoulder, but that requires the accessory kit. For savant learning, the electrodes need to
be placed on the left and right side of the head. Fortunately, the foc.us headset is very versatile and
includes he ability to use external electrodes as needed.
Using the External Electrodes
You have to give foc.us some applause. They designed a great deal of capability in to a fairly inexpensive
package. This is the first really versatile tDCS device that has a clean, simple design, has high ease-of-use
and doesnt cost a fortune as many other commercial offerings do. tDCS is now within reach of
many more who really need it! For those not satisfied with the built-on electrodes, you can do your own
thing for special treatments or research with the accessory kit. It includes necessary wires (and other
items) along with a small number of TENS style stick-on electrodes.


(Accessory anode and cathode wire plugged into the back of the headset)
Important: The Wires
The kit includes a two-wire (anode & cathode) lead with good length, allowing placement pretty much
as you see fit. Uniquely, there is a single wire anode and single wire cathode included too. These are
very useful when you want to use the built-on anode (or cathode) and have the opposite charge applied
at a non-standard location. As mentioned, for depression, users may prefer the built-on anode, but
want the cathode placed on the right shoulder. The single cathode wire makes this simple to do.

(Single electrode plugged in to the back of the headset)
CAUTION: Voltage continues to be available via the built-on electrodes even if one of the accessory
leads is plugged in. You will need to remove the appropriate sponges (cathode or anode) when using an
accessory wire. So for example, a person seeking to treat depression would leave the anode (left)
sponges in place, remove the cathode sponges (right side), and then use the cathode wire to place an
electrode on the right shoulder.
If you leave sponges out, you need to be VERY CAREFUL that skin cannot come in contact with the
copper plate inside the sponge holder (from an odd skin-wrinkle or tag.) If it does, a burn could result.
Perhaps the iOS/Android apps will allow disabling unused built-on electrodes well have to wait and
see.
CAUTION: The plus and minus marking on the anode and cathode leads is BARELY visible and could
easily lead to an error. I suggest MARKING the leads in some much more visible manner (I used red and
black zip-ties for the purpose.)


(Can you see the minus sign on the back of the electrode clip? Its very hard to see.)


(You will want to clearly mark lead polarity. Zip ties work.)
Use Your Own Electrodes with the foc.us tDCS Headset
The foc.us headset comes with built-on sponge electrodes and has the ability to support wire connected
electrodes via a small connector on the back. You can buy the accessory kit from foc.us and in it receive
wire connections for snap-type electrodes (stick-on). For anyone with hair (not me sorry to say), you
may want to use sponge electrodes (like the popular Amrex 22 or 33). The Amrex electrodes use
banana style connectors so you must adapt the foc.us wires or create your own. I chose the latter
route.
Heres what you need:
1. Radio-Shack PN 273-334 Adaptaplug type A it measures 2.35mm OD x 0.7mm ID (or a pre-
built cable with a 2.35mm x 0.7mm plug already installed available on EBay and other
sources).
2. Wire with the desired connector type at one end. I prefer alligator-clips as they provide great
flexibility.
3. Head-shrink tubing (available at Radio Shack)
4. Solder and soldering iron
You can see from the picture below that if you are looking at the back of the connector, pins down, the
pin to the right is the Anode (+) when plugged into the headset (I checked this with a DVM). I marked
that side of the connector with a red sharpie.

(RS PN 273-334 with red mark for anode lead.)
So all that has to be done is solder your leads to the pins, use some heat-shrink tubing to cover them
and away you go!

(Assembled plug with alligator leads.)
Wire color does not matter. I just happened to have a bunch of green and yellow clip leads. In this case, I
soldered the yellow lead to the anode pin. With the adapter complete, you have much more flexibility
using whatever electrodes you like with the foc.us headset.

(You may prefer to buy a cable like this and add
lead-wire and connectors that you prefer. Pre-assembled
cable from EBay about $3 with shipping!
Search for 2.35mm DC cable.)
If you buy a pre-built cable, verify which lead is the anode (plus) and which is the cathode with a digital
volt meter (DVM) to be safe.
One more thought: The connector used for external electrodes is a bit fragile. You might want to
consider using some Velcro or similar material to provide some strain relief if you frequently use
external electrodes.


(A Velcro wrap used for strain relief)
Electrode Placements
Ive had repeated requests to show electrode placements for various scenarios using the foc.us headset.
As you look at what I show below, remember, they are just examples. There are alternative placements
and new tDCS montage information being published frequently! What I hope to convey is the versatility
the foc.us headset provides through various electrode placements. So here we go
DEPRESSION
A common depression treatment montage using tDCS places the anode at F3 (high on the left forehead)
and the cathode at FP2 (just above the right eye on the forehead). The unusual foc.us built-on
electrode placement puts the anode at FP1 and F3 and the cathode at FP2 and F4. So yes, it supplies
current in the general area suggested for depression treatment. Has this unusual arrangement been
scientifically studied? Not to my knowledge. There is anecdotal evidence to indicate that it works well
though.
An alternative is to remove the cathode sponges from the headset and use the cathode wire (black) to
place that electrode on the right shoulder.

SAVANT LEARNING
This montage is been in the press of late and is easy to do with the foc.us headset with the accessory kit.
Normally, the anode is placed at about T4 (the right temple) and the cathode at about T3 (the left
temple.) Savant Learning is an overly broad term that refers to improved intuition, creativity, and
ability of the right brain to dominate. The montage involves placing the anode high on the right temple
and the cathode high on the left temple.

(Electrodes are placed on the temples for savant learning.)
When you use the wire electrodes, remember that the built-on electrodes remain active. You can use
them if appropriate or remove the sponges to not use them. In this case, the built-on electrodes are not
used at all in fact you can take the headset off and set it on your desk or do what I do, just let it rest
on your neck.)

(The foc.us headset can rest on your desk when using wire electrodes.)
MEMORIZATION and LEARNING
An interesting memorization and learning montage involves placing the anode at FP1 (above the left eye
on the forehead) and the cathode at FP2 (above the right eye on the forehead).

(Memory and Learning Montage. There are other variations of learning electrode placements available
on the web.)
As with the depression montage shown earlier, the unusual placement of the built-on electrodes is
more than required for this montage. Some users suggest possibly leaving out the upper sponges to
more precisely match the montage requirements. However, current density could be too high and
irritation might result as the sponges are small. Using external electrodes is probably better.
CHRONIC PAIN
Chronic pain is addressed in at least a couple of different montages. One example is to place the anode
at C4 (above the right ear, halfway to the center of the head) and the cathode at FP1 (above the left eye
on the forehead). There are other montages for chronic pain so look those up on the web if the one I
show is not what you are looking for.) Another montage places the anode at either C3 or C4 and the
corresponding cathode at FP1 or FP2 on the same side of the head (left or right) to treat chronic pain on
the opposite side of the body (left or right).

(One of the reported chronic pain montages reported on the internet.)
This is another example of how versatile the foc.us headset can be. Use the wire electrodes for this
chronic pain montage and set the headset on your desk or leave it resting on your neck with no
sponges.
Wrap-Up
So there you are four examples of tDCS montages using the foc.us headset with external electrodes.
What a great and versatile product! There are many variations on tDCS montages reported in studies
and articles that appear on the internet. Do your homework! Remember, no matter what montage you
are using, stay within safety guidelines for current and time. No more than 2 mA and no more than 30
minutes per day of tDCS.
Coming Soon
This document will be updated with new material on a regular basis. Check back for additions, updates,
and corrections.
Your comments and suggestions are welcome. Please send them to brent@speakwisdom.com