DEPARTMENTS: Reviews of Rehabilitation Technology Web Sites
Noninvasive brain stimulation is a new area that has seen an explosion in off-label clinical applications since repetitive transcranial magnetic stimulation (rTMS) received FDA approval for the treatment of depression. The Berenson-Allen Center for Noninvasive Brain Stimulation (BACNBS) at Beth Israel Deaconess Medical Center and Harvard Medical School has been a leader in noninvasive brain stimulation, and its copyrighted Web site serves as a good resource for patients and clinicians interested in a general overview (http://tmslab.org/, reviewed February 1, 2012).
The BACNBS states that it has a threefold mission—research, education, and patient care—and the Web site nicely addresses each area. The Research tab does a cursory job, highlighting various aspects of brain dynamics, plasticity, and disorders. The intent of this section appears to be to emphasize the areas of research performed by the laboratory rather than to be a comprehensive overview. This is not clearly stated as such, however, and is thus a limitation. Most articles are cited with a link to the PDF, which is of added benefit to those seeking more detailed information and methodology. BACNBS offers educational seminars for professionals in noninvasive brain stimulation. Up-to-date information, including a description of the course, dates offered, cost, and accommodations for these seminars can be found under the Education tab. The patient care page has a professionally made video of a patient who is currently being treated with rTMS for depression. The video includes an interview with the patient, discussing his experiences with depression and rTMS, and shows him undergoing an rTMS treatment. Additional videos are also available, such as other patient videos, a video on noninvasive brain stimulation from NOVA, and an explanation of deep brain stimulation. In addition, the patient care page has tabs that describe (1) different methods of noninvasive brain stimulation, such as transcranial direct current stimulation (tDCS); (2) what to expect upon your visit; (3) patient stories; and (4) a list of the BACNBS team and their experience. This section of the Web site is very well constructed and should address most patient questions. One important aspect that is not addressed is the contraindications or risks associated with the technology.
The remaining aspects of the site are not well developed. There is information about the equipment and use of the facility available under the TMS Core tab. Here, a professional can request the use of the equipment and space for various neuroscience experiments that require noninvasive brain stimulation. No indication is given as to what qualifications are required or the rates. No entries are included under the Blog tab.
Overall, this is a good, accurate Web site that primarily provides information to patients regarding what to expect during an rTMS session and highlights the research of the sponsoring center. It is also helpful for professionals who are not currently aware of the technology in that it gives a brief introduction. Patients will not be overwhelmed, as the site is easily navigable. The primary limitations are the lack of more comprehensive information about other emerging neuromodulation applications, risks, and other sources for more information.
Teresa Jacobson Kimberley, PT, PhD and Sharyl Samargia
University of Minnesota, Minneapolis.