Neuroelectrics User Manual

– P2. Electrodes –

CAUTION: INVESTIGATIONAL DEVICE

Limited by United States law to investigational use.
(XURSH2ႈFH
Avinguda Tibidabo, 47 bis
08035 Barcelona, Spain
Tel. +34 93 254 03 66
Fax. +34 93 212 64 45

862ႈFH
210 Broadway, Suite 201
Cambridge, MA 02139, USA
Tel. +1 617 390 6447

Email: info@neuroelectrics.com

www. neuroelectrics.com

Copyright© by Neuroelectrics®. All rights reserved.

0DQXIDFWXUHU
Neuroelectrics Barcelona SLU
Avinguda Tibidabo 47, bis
08035 Barcelona
Spain
Telephone: + 34 93 254 03 70

0DQXDO8SGDWH
Version: 1.4
Date: 2018.09.18
 About the Electrode User Manual
The (OHFWURGH8VHU0DQXDO belongs to the 3DUW,, of the Before you first use the Enobio/Starstim system, you should
Neuroelectrics User Manual. read the three parts of the Neuroelectrics User Manual.
The Electrode User Manual does not discard the need of
reading the Enobio/Starstim and NIC parts.
The1HXURHOHFWULFV8VHU0DQXDOincludes three parts:
The PDF version of all parts of the Neuroelectrics User
X 3DUW, Enobio User Manual or Starstim User Manual Manual can be found under the Documentation section of
X 3DUW,, Electrode User Manual Neuroelectrics webpage:
X 3DUW,,, NIC User Manual www.neuroelectrics.com /documentation

4
Change Record
,VVXH 'DWH &KDQJHVPDGH

1.0 2016.02.18 Neuroelectrics User Manual: Electrode part creation

1.1 2017.02.28 NG Electrodes update

1.2 2017.05.12 Added Drytrode caution

1.3 2017.07.25 Safety warnings for stimulation & Sponstim maintenance update

1.4 2018.09.10 Solidgeltrode removed, NG geltrode updated

5
 Table of Contents
About the Starstim User Manual .........................................4 X. 6WLFNWURGH ................................................................ 18
Change Record ...................................................................5 XI. 05,6WLFNWURGH ......................................................... 19
XII. (DUFOLS ......................................................................20
I. ,QWURGXFWLRQ ................................................................7 XIII. $FFHVVRULHV ............................................................. 21
II. *HOWURGH ......................................................................8 XIV 6LOYHU6LOYHU&KORULGH$J$J&O
III. 1**HOWURGH ................................................................9 (OHFWURGH,QVWUXFWLRQV.............................................22
IV. )RUHWURGH .................................................................. 10 XV. 6DIHW\,QIRUPDWLRQIRU6WLPXODWLRQ ....................... 24
V. 'U\WURGH ................................................................... 11 XVI.1 Safety Warnings ..............................................25
VI. 3LVWLP........................................................................ 12 XVI.2 Safety Guide ...................................................26
VII. 1*3LVWLP ................................................................. 13 XVI.3 Dosage ............................................................26
VIII. 6SRQVWLPV ................................................................ 14
IX. 05,6SRQVWLPV ........................................................ 15

6
I. Introduction
Currently, Neuroelectrics provides functionality of each type of electrode included in our MRI kits.
distinct types of electrodes: 10 and always use it accordingly. In
designed by Neuroelectrics general, the electrodes can be used
and 2 externally manufactured. either for EEG monitoring, or for brain
The electrodes designed and stimulation. The only exception, is our
manufactured by Neuroelectrics are unique model named Pistim, which
intended to be used exclusively with can be used for both techniques.
Neuroelectrics devices, like Enobio or Additionally, we also have three types
Starstim, and they are not compatible of electrodes that can be used as the
with any other commercial device. electrical reference for our devices.
Finally, because you might want
In this manual, all the electrodes
to combine brain stimulation with
commercialized by Neuroelectrics are
magnetic resonance imaging (MRI),
described. For each type of electrode,
we also provide MRI compatible,
you may find the corresponding use
stimulation and reference, electrodes.
instructions and the guidelines on how
to clean and store the electrode. You All the electrodes are compatible
will find here all types of electrodes: with the easy-insert system of the
the standard EEG electrode to be used Neuroelectrics neoprene headcap
with conductive gel, dry electrodes and headband, both included in the
that require no contact liquid, sponge Enobio and Starstim packages. All of
stimulation electrodes to be used with them are compatible with the electrode
saline solution, and new electrodes cables included in the packages,
that use a solid form of conductive except the MRI compatible electrodes
gel. Pay special attention to the which require special cables, that are

7
 ,,
*HOWURGHThe standard EEG electrode

'HVFULSWLRQ 0DLQWHQDQFH 'XUDELOLW\

The Geltrode has a Ag/AgCl coated After each use, clean the Geltrode
core of 12 mm diameter. It has a using a water, a tissue and a cotton
rear-fill aperture and the contact area swab. The conductive gel should be
is approximately 1 cm2. completely removed because it might
degrade the electrode. Avoid the direct
sunlight exposure and the contact
8VH,QVWUXFWLRQV
with metals when the electrode is not
being used. The better the Geltrode is
AF8 cleaned, the longer it lasts. If properly
AF8 AF8

Name: GELTRODE AF8 AF8 AF8

cleaned and maintained, the Geltrode
Code: NE022
AF8 AF8 AF8

Function: EEG can be used, on average, 30 times.

When the electrode reaches the end
The Geltrode is a wet EEG electrode of its lifetime, the coating starts to wear
that provides a rear-fill aperture for and tear which will produce a noisier
gel supply. It requires the use of the 1 Insert the electrode in the desired signal and consequently decrease the
conductive electrode gel, and it can position of the neoprene cap. quality of the EEG.
be used in scalp areas with or without
2 Place the cap on the subject.
hair.
3 Use the curved syringe to inject the
conductive gel through the hole on the
top of the electrode.
4 Connect the medical sockets of
the electrode cable to the electrodes
inserted on the cap.

8
,,,
1**HOWURGH The next generation gel electrode

'HVFULSWLRQ 7REHXVHGZLWKWKHVROLG
FRQVXPDEOH
The NG Geltrode consists of two
pieces: the fastener (superior part) and 1 Insert the threaded washer in the
the threaded washer (inferior part). desired position of the neoprene cap.
The fastener is based on a Ag/AgCl
sintered pellet with a 4 mm diameter. It 2 Put the cap on and use a cotton
has a rear-fill aperture and the contact swab, after being immersed in a water
area is approximately 1 cm2. and glycerin solution (1:1), to part the
hair and to clear the scalp through the
washer.
Name: NG GELTRODE 8VH,QVWUXFWLRQV
Code: NE032
Function: EEG 7REHXVHGZLWKJHO
Based on the next generation (NG) 1 Insert the threaded washer in the
assembling system, the NG Geltrode desired position of the neoprene cap.
is a EEG electrode that allows the
2 Place the cap on the subject.
access to the scalp through the
headcap. It can be used wet with gel, 3 Use the curved syringe to fill in the
3 Insert the solidgel consumable
we recommend Signa Gel® or dry fastener with conductive gel.
inside the threaded washer.
with solidgel technology. The solid-gel
4 Screw the fastener on the washer.
technology is the only of its kind that
uses a solidgel consumable placed 5 Connect the electrode cable
into the electrode for EEG monitoring. connection to the fastener.

9
 4 Screw the fastener on the washer. &OHDQLQJ
After each use, wash the NG Geltrode
with tap water and use a tissue to
complete the cleaning.

0DLQWHQDQFH
Avoid direct sunlight exposure and
contact with metals when the electrode
5 Connect the electrode cable is not being used.
connection to the fastener.
'XUDELOLW\
The NG Geltrode is a long lasting
electrode that can be reused many times.
Its intended number of uses is 100.

10
,9
)RUHWURGHThe forehead EEG electrode

'HVFULSWLRQ 0DLQWHQDQFH 'XUDELOLW\

The Foretrode is based on a Ag/AgCl After each use, clean the Foretrode
sintered pellet with an approximate using a tissue and water. The
area of 0.1 cm2. conductive gel should be completely
removed because it might degrade
the electrode. Avoid direct sunlight
8VH,QVWUXFWLRQV
exposure and contact with metals
when the electrode is not being used.
AF8 The better the Foretrode is cleaned,
AF8 AF8

AF8 AF8
AF8
AF8
the longer it lasts. If properly cleaned
AF8 AF8

Name: FORETRODE and maintained, the Foretrode can be

Code: NE021
Function: EEG used approximately 100 times.

The Foretrode is the ideal EEG

electrode to be used on bare-skin 1 Insert the electrode in the desired
scalp areas, like the forehead. The use position of the neoprene cap.
of gel on the tip is optional.
2 Inject a small portion of conductive
gel in the contact surface of the
electrode (optional).
3 Connect the medical sockets of
the electrode cable to the electrodes
inserted on the cap.
4 Place the cap on the subject.

11
 9
'U\WURGHThe dry EEG electrode

'HVFULSWLRQ 0DLQWHQDQFH 'XUDELOLW\

The Drytrode is a Ag/AgCl coated After each use, clean the Drytrode
electrode that provides a 10-point using a tissue. If needed, you may use
contact surface. water to complete the cleaning. Avoid
direct sunlight exposure and contact
with metals when the electrode is not
8VH,QVWUXFWLRQV
being used. The Drytrode is a long
lasting electrode so it can be reused
AF8 many times. Its intended number of
AF8 AF8

AF8 AF8
AF8
AF8
AF8
uses is 100. AF8

Name:
DRYTRODE
Code: NE023

The Drytrode is a dry EEG electrode.

It does not required the application of 1 Insert the electrode in the desired
any type of gel between the electrode position of the neoprene cap.
and the scalp. It can be used in
2 Attach the necbox and the electrode
scalp areas with or without hair. The
cable to the cap, and connect one to
Drytrode was specially designed
the other.
for fast applications out of the lab or
requiring a gel-free experience. It is 3 Connect the medical sockets of
the perfect electrode when the ease of the electrode cable to the electrodes CAUTION: Please make sure there is
use is more important than the quality inserted on the cap. no excessive pressure or force on the
of the signal, like in BCI applications. head while using the Drytrode.
4 Put the cap on.

12
9,
3LVWLPThe hybrid tCS & EEG electrode

'HVFULSWLRQ 4 Use the curved syringe to inject

more electrode gel, through the hole of
The Pistim provides a /cm2 circular
the electrode.
contact area and a rear-fill aperture for
gel supply. It is based on sintered 5 Connect the medical sockets of
Ag/AgCl pellet of 12 mm diameter. the electrode cable to the electrodes
previously placed on the cap.
8VH,QVWUXFWLRQV
0DLQWHQDQFH 'XUDELOLW\
AF8 After each use use a cotton swab
AF8 AF8

Name: PISTIM AF8 AF8 AF8

and water to completely remove
Code: NE024 AF8 AF8 AF8

Function: EEG and Stimulation the gel from the Pistim. When the
electrode is not being used, avoid
The Pistim is a unique electrode due direct sunlight exposure and contact
to its dual functionality: it works for with metals. Each electrode should be
stimulation and for EEG monitoring. 1 Insert the electrode in the desired replaced after 10 hours of stimulation
Thus, it is the ideal electrode when position of the neoprene cap. because the Ag / AgCl is expected
EEG monitoring is required in a to be consumed. Nevertheless, the
2 Use the curved syringe to inject
stimulation session. Further, due time of the Ag / AgCl consumption
conductive gel in the contact surface
to its reduced size, it is perfect for depends on the type and intensity of
of the electrode.
focal multi-electrode stimulation the stimulation current.
experiments. Read the Safety 3 Place the cap on the subject.
Information for Stimulation chapter
before using this electrode.

13
 9,,
1*3LVWLP The next generation hybdrid electrode

electrode.
'HVFULSWLRQ 0DLQWHQDQFH 'XUDELOLW\
The NG Pistim consists of two pieces: After each use use a cotton swab
the fastener (superior part) and the and water to completely remove
threaded washer (inferior part). It the gel from the NG Pistim. When
provides a /cm2 circular contact area. the electrode is not being used,
It is based on sintered Ag/AgCl pellet avoid the direct sunlight exposure
of 12 mm diameter. and the contact with metals. Each
electrode should be replaced after
10 hours of stimulation because the
Name: NG PISTIM 8VH,QVWUXFWLRQV
Ag / AgCl is expected to be consumed.
Code: NE029
Function: EEG and Stimulation 1 Insert the threaded washer in the Nevertheless, the time of the Ag / AgCl
desired position of the neoprene cap. consumption depends on the type and
Based on the next generation (NG) intensity of the stimulation current.
2 Place the cap on the subject.
assembling system, the NG Pistim
is the only hybdrid electrode that 3 Use the curved syringe to fill in the
provides a clear access to the scalp, fastener with conductive gel.
allowing good control over the
4 Screw the fastener on the washer.
impedance values. Similarly to the
regular Pistim, the NG Pistim is a 5 Connect the electrode cable
hybrid electrode that can be used for connection to the fastener.
stimulation and for EEG monitoring.
Read the Safety Information for
Stimulation chapter before using this

14
9,,,
6SRQVWLP¶VThe stimulation electrodes

'HVFULSWLRQ FC2

The Sponstim consists of a sponge

C4
F4
CP6
P4
AF4
FC6

cover, a carbon rubber core and a AF8

AF8
F8 T8
P8

metallic pin made of nickel plated P08

brass. The contact surface differs

among the three models: (a) circular
shape with 25 cm2, (b) circular shape 4 If the impedance check failed, add
with 8 cm2, and (c) rectangular shape more saline solution on the yellow
with 35 cm2 (5 cm x 7 cm). surface of the sponges by inserting the
syringe through a hole of the cap near
Name: SPONSTIM 25 / 8 / 5x7 the electrode.
Code: NE026 a / b / c
Function: Stimulation

0DLQWHQDQFH 'XUDELOLW\
The Sponstim’s are sponge electrodes
for transcranial stimulation. They are After each use, wash the sponges and
available in three different sizes and rubber separately with tap water and let
shapes. The smallest model, with 8VH,QVWUXFWLRQV them dry before storage. The cleaner
a contact area of 8 cm2, is ideal for Sponstim is kept, the longer it lasts.
1 Inject 5 ml ( Ⱥ 1/2 curved syringe) When stored, make sure the metallic
multifocal stimulation experiments. The
of saline solution on the yellow pins do not come into contact with
Sponstim electrodes work with saline
external surface of the sponge of each the sponges, so they do not become
solution, not with electrode gel. Read
electrode. rusty. After 100 hours of stimulation,
the Safety Information for Stimulation
chapter before using these electrodes. 2 Insert the electrodes in the desired the rubber core loses its conductive
position of the neoprene cap. properties, and the electrode should be
replaced.
3 Place the cap on the subject and
connect the medical sockets to the
electrodes.
15
 ,;
05,6SRQVWLP¶VThe MRI compatible stimulation electrodes

'HVFULSWLRQ 0DLQWHQDQFH 'XUDELOLW\

The MRI Sponstim consists of a After each use, wash the sponges
sponge cover and a carbon rubber and rubber separately with tap water
core, both radiotranslucid materials. and let them dry before storage. The
The contact surface differs among the cleaner Sponstim is kept, the longer
three models: (a) circular shape with it lasts. After 100 hours of stimulation,
25 cm2, (b) circular shape with 8 cm2, the rubber core loses its conductive
and (c) rectangular shape with 35 cm2 properties, and the electrode should be
(5 cm x 7 cm). replaced.
Name: MRI SPONSTIm 25 / 8 / 5x7
Code: NE026MRI a / b / c
Function: Stimulation (MRI compatible)
8VH,QVWUXFWLRQV
The MRI Sponstim requires the use
The MRI Sponstim’s correspond of saline solution. It can be used for
to the MRI compatible version of bipolar or multi-channel montages.
the Sponstim’s. The three distinct The MRI compatible electrode cables
models can be used to perform brain required come included with the MRI
stimulation in a subject undergoing compatible kits for stimulation prepared
an MRI experiment. Similarly to by Neuroelectrics. The instructions to
the Sponstim, the MRI Sponstim assemble the MRI compatible kits are
electrodes require the application described in the MRI Kits Manual at:
of saline solution. Read the Safety
http://www.neuroelectrics.com/
Information for Stimulation chapter
documentation
before using these electrodes.

16
;
6WLFNWURGHThe EEG reference electrode

'HVFULSWLRQ 3 Place the second electrode (DRL)

inferiorly to the CMS electrode.
The Sticktrode is a pre-gelled electrode
with an adhesive side with non-irritating
gel and a 24 mm diameter.

8VH,QVWUXFWLRQV
1 Remove the adhesive cover.

4 Connect the CMS and DRL cable

Name: STICKTRODE connections to the corresponding
Code: NE025
Function: Reference stick.

The Sticktrode is a disposable pre-

gelled electrode. It is an easy-to-use 2 Place the first electrode (CMS) on
adhesive electrode. When a pair the mastoid and ensure there is no
is placed on the bare skin mastoid hair underneath.
and connected to the CMS and DRL
channels, it works as an electrical 0DLQWHQDQFH 'XUDELOLW\
reference of the EEG system.
Additionally, it can be used for ECG, The shelf life of the electrode is 24
EMG or EOG (when placed near the months when stored at 10 - 30ºC
eye). The original manufacturer is temperature. The Sticktrode is a
Covidien and the code of the model is disposable, it should be used only
H124SG. once.

17
 ;,
05,6WLFNWURGHThe MRI compatible EEG reference electrode

'HVFULSWLRQ
The MRI Sticktrode is a pre-gelled
electrode with a circular latex-free
contact surface with 41 mm diameter.
It contains a Ag / AgCl laminated core
with a carbon composition contact with
a 11 mm diameter.

8VH,QVWUXFWLRQV
Name: MRI STICKTRODE A pair of MRI Sticktrodes should be
Code: NE025MRI
Function: Reference placed on the mastoid, with CMS
superiorly to DRL, as described on
steps 2 & 3 in the previous page.
The MRI Sticktrode is a disposable The MRI Sticktrodes are then
and radiotranslucent pre-gelled connected to MRI compatible electrode
electrode. It is similar to the Sticktrode cables. The MRI Sticktrodes and the
and it has the advantage of being MRI electrode cabes are included in
compatible with MRI (up to 7T, with any the MRI compatible kits for stimulation
scanning sequence). Therefore, it is the prepared by Neuroelectrics. The
reference electrode that should be used instructions to assemble the MRI
for stimulation sessions performed compatible kits are described in the
simultaneously with MRI. The original MRI Kits Manual at:
manufacturer is BIOPAC Systems,
Inc and the code of the model is: PK- http://www.neuroelectrics.com/
EL508. documentation

18
;,,
(DUFOLSThe dual reference electrode

'HVFULSWLRQ &OHDQLQJ
The Earclip consists of two opposed After each use, clean the Earclip using
Ag / AgCl pellets of 8 mm diameter in a a tissue. If needed, you may use water
clip. Each one of the two pellets has a to complete the cleaning.
0.5 cm2 contact surface.
0DLQWHQDQFH
8VH,QVWUXFWLRQV
Avoid direct sunlight exposure
and contact with metals when the
Name: EARCLIP
Code: NE027
electrode is not being used.
Function: Reference

'XUDELOLW\
The electrical reference Earclip is
a dual electrode used to connect The Earclip is a long lasting electrode
both CMS and DRL simultaneously so it can be reused many times. Its
to the same earlobe. Compared to intended number of uses is 100.
the Sticktrode, the Earclip is a re- 1 Connect the CMS and DRL cable
usable alternative that offers a quick connections to the Earclip.
assembling process.
2 Apply some electrode gel to the
sensors (recommended).
3 Clip it to the right or left earlobe.

19
 ;,,,
$FFHVVRULHV

&XUYHGV\ULQJH (OHFWURGHJHOJ 6DOLQHVROXWLRQPO *O\FHULQVROXWLRQPO

NE014 NE016a / NE016b NE033 / NE034 NE152

The 12 ml curved syringe The electrode gel is a The saline, or sodium The glycerin solution is
is used to inject either highly conductive and chloride, solution (NaCl 0.9%) used to clear the scalp area
electrode gel or saline in the bacteriostatic gel. It is a is needed to use the sponge before inserting the solid gel
electrodes. water soluble, non-staining electrodes for stimulation: consumable in the threaded
and non-gritty. Sponstim’s and MRI washer of the Solidgeltrode.
With the Geltrode and
Sponstim’s.
the Pistim, the curved tip It is used for EEG monitoring Use a cotton swab to apply.
of the syringe should be electrodes and for the hybrid It should be applied in the
inserted on the small hole EEG/tCS Pistim electrodes. yellow external surface of
of the electrode to inject the It is used to improve the the sponge. Ideally, 5 ml
electrode gel into the rear-fill contact between the (half of the curved syringe)
aperture. electrode and the scalp by of saline solution should be
decreasing the impedance. enough per sponge. If the
With the Sponstim’s it is
electrode impedance is not
used to soak the yellow
as good as desired, more
sponge surface.
solution can be added.

20
6ROLGJHOFRQVXPDEOHV
NE032

The solid gel consumable is

a highly conductive electrode
gel in its solid form. It is used
for EEG monitoring with our
NG geltrode.

21
 ;,9
6LOYHU6LOYHU&KORULGH$J$J&O(OHFWURGH,QVWUXFWLRQV

3UHFDXWLRQVIRUKDQGOLQJ &OHDQLQJ After most electrode applications,

WKHHOHFWURGHV rinsing with distilled water suffices.
The Ag/AgCl electrodes behave like
Should the electrode surface be
The electrodes should not come sponges: they absorb water and
especially dirty or corrode, a new
into direct contact with metals as electrode gel. The deeper these liquids
surface can be exposed by gently
this may cause corrosion. Avoid penetrate the electrode, the longer it
sanding off with fine sandpaper or
touching or contaminating the bare takes to them to evaporate. Corrosion
abrading with a pumice cleanser (do
electrode surface as dirt can increase will take place as a consequence and, in
not use ordinary cloth). Follow by
adjustment times. Use of corrosive the long term, it will make the electrodes
rinsing thoroughly with running water,
chemicals will damage the electrodes. noisier and decrease the signal quality.
drying and storing to allow them to dry
Therefore, it is highly recommended
completely before the next use.
to clean and let the electrodes dry
&RQGLWLRQLQJ
immediately after use.
To minimize DC offset and drift, 'LVLQIHFWLRQ
To clean this type of electrodes, tap
place the electrodes in the working
water is used to rinse the gel from the When disinfection is required, only
position 5 minutes before starting
electrodes. Warmed up 50 ºC, the water gas or liquid agents should be used.
the recording. The electrodes need
will dissolve the gel more quickly. Only if Disinfectants containing mercury,
some time to achieve electrochemical
necessary, you may use soap and/or a phenols, bromine, iodine, zinc, tin, and
equilibrium with the skin and with the
soft brush to remove gel residues from organo-metallic compounds should
electrolytes of the human body.
the electrodes. Make sure to keep the be avoided. Also, the electrodes and
connector always dry. Let them hang cable insulation can not withstand
to dry or use a paper towel softly. Do steam.
not let the electrodes dry without being
cleaned first. When the electrodes dry
while covered with gel, salt or minerals,
the cleaning process becomes more
difficult.

22
'DUNHQLQJ 0DOIXQFWLRQ /LIHH[SHFWDQF\
Silver chloride is light-sensitive. If an electrode is not operating as Ag/AgCl sintered electrodes have
Exposure to light will darken the specified and you experience noise, a limited life span. This is caused
electrode surface. This will not impair then please follow the directions below by several processes such as
the electrode performance since the concerning noisy electrodes. corrosion, the dissolving of the
large interstitial Ag/AgCl matrix is not chloride in the pellets and the wearing
reached by light. of the pellet during the cleaning
1RLV\HOHFWURGHV
proccess. Eventually, the color of
A continuously noisy electrode the pellets will change from grey/
6WRUDJH
generally means that it has reached brown (AgCl) to silver (Ag) due to
The electrodes should be handled its end of life. You can extend the life the loss of the chloride. The AgCl
with care. They must not be stored in time a little bit by using a grain 600 or slowly dissolves in gel and water
contact with metals, especially active higher waterproof abrasive paper to during the cleaning, which leaves
metals such as iron or aluminum. polish the electrode tip. For that, use only Ag behind. The resulting pure
Substances that could affect their very soft and circular movements, silver electrode has much higher drift
electrochemical characteristics should preferably no more than 2 or 3 times and noise characteristics than the
also be avoided. Bare electrodes on the same area and removing an original Ag/AgCl electrode. At this
should be stored in a clean, dry and even very thin layer across the entire point, replacement of the electrode is
dark container (plastic or glass). surface. required.

23
 XVI. Safety Information
for stimulation

24
;9,
Safety Warnings

W If the contact impedance of a specific 40 minutes are for research purposes only.
HOHFWURGHLVDERYHNȍWKHFRUUHVSRQGLQJ
channel of the Starstim will not work.
W Electrode positions above cranial foramina and fissures
should be avoided because the effective current density
W The maximum current allowed at any can increase beyond safety limits in these areas.
channel is ± 2 mA, with a maximum
potential difference of 30 V (± 15 V).
W The Neuroelectrics stimulation electrodes
should be used only with Starstim.
W The maximum total injected current
W Before stimulation, confirm the condition of
allowed, at any time, is 4 mA.
the electrodes and check if they are clean.
W Based on the literature, the guideline for clinical use is
W Electrodes should only be used with the
to keep average current densities in electrodes below
conductive gels and solutions specified in this
0.06 mA/cm2
manual. Do not use other gels or solutions but
(= 2 mA / 35 cm2). In this way, the stimulation
those recommended in the Use Instructions.
current densities are far from the threshold for
tissue damage (14.3 mA/cm2) indicated for tDCS. W Perform a careful inspection of the skin under the
stimulation site before and after the stimulation
W Current densities above 0.06 mA/cm2 (but always
session. Observed adverse effects include: skin
well below 14.3 mA/cm2) are for advanced
itching, tingling, headache, burning sensation,
clinical research or research puposes only.
and discomfort. In rare cases, skin lesions have
W Stimulation session durations beyond been observed. If any of the mentioned effects

25
 ;9, ;9,
Safety guide Dosage

The following chart is provided to guide above )RUWKHႋLPXODWLRQXVLQJ6WDUႋLP1,&

operators, providing safety zones for 2 mA / 35 cm2. software provides an informative value
different electrode current densities. about the dosage of a session. The
With regards to the use of small
Note this is an updated chart from 2012 dosage is the amount of charge that
electrodes in tCS, it is worthwhile
version. The only change is the removal the user receives during the session,
noting that the ratio of currrent/area
of the “Uncharted Territory“ zone. and it is calculated using the equation
(I/A) is not a good indicator of cortical
Since 2013 several groups have been
electric field magnitude. For smaller
working with the Pistim electrode using
electrodes more current than predicted
up to 2 mA of current intensity and no ill
by the I/A ratio was required to achieve
effects have been reported.
a predetermined current density in the
The chart illustrates the maximum brain.
(MAX) average current density that
In the last few years several studies
can be used for mainstream clinical
applications, advanced clinical (Eq. 1)
Eq. 1.
applications, and research as function of
the electrode size.

,PSRUWDQWQRWH
The proposed limits are not based
on available negative evidence, i.e.
findings of adverse effects with higher
current densities. Rather, they are a
conservative statement based on the
limited experience with current densities

26