Go Flow Pro

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Go Flow
Go Flow 1.jpg
Category Transcranial direct-current stimulation
Developer Transcranial Ltd.
Announced November 2015 [1]
Released Developers:
Consumers: January 2016 [1]
Price 99 USD / 129 USD Go Flow Sports (November 2016) [2]
Max output 2.2 mA2.2 T
0.0022 A
[3]
Session duration 2100 s35 minute
[3]
Scalp location T3, C3, C1, C2, C4, T4. F3, F4. Fp1, Fp2 [4]
Weight 10 g [4]
Controls

button [4]

Data available
Risk factor
Medical prescription No
http://foc.us/

Go Flow is a small device that provides a certain form of brain stimulation, namely, transcranial direct-current stimulation (tDCS). The device was developed by the London-based company Transcranial Ltd., even though the similar title GoFlow was also used by one of the first tDCS devices that was produced by students at the University of Michigan and was never shipped.[5] The device consists of two electrodes, a Go Flow tDCS stimulator, two cables, a 9V battery, and a band or cap that holds the electrodes on the user's head. Go Flow Sports also includes an armband.[4]

There are two types of devices that sell under the name 'Go Flow Pro' and 'Go Flow Sports'. The former device was intended to be low-cost and reliable DIY (do-it-yourself) tDCS[1], even though in accordance with Wexler's terminology it could be more appropriately entitled a DTC (direct-to-consumers) device. It is not developed by its users but it is shipped to them.[5] The latter type of the device is a device that should enhance physical performance.[4]


Main Characteristics

Go Flow is a standalone and fully enclosed head-mounted tDCS device. The set includes the brain stimulator, two sponge electrodes, a band (respectively, a cap with armband), two cables and a 9 V battery.[4] The device is intended as a DIY tDCS device; thus, components could be bought separately.[2] In addition, sticky electrodes with hydrogel could be used with the device.[6]

The Go Flow brain stimulator is a small plastic box measuring 26 mm x 28 mm x 16 mm. It contains one button that controls the setup of each session. There are also orange and green LED lights that indicate the output of the device and the duration of the session. The output can vary from 0.5 mA to 2 mA, and the session duration can vary from 5 minutes to 35 minutes.[4]

Go Flow tDCS stimulator with battery

The device consists of two electrodes: X and Y. 'X' is a title for an anode and 'Y' for a cathode. Each electrode also has a cable. The original package contains sponge electrodes that have to be moistened by water or saline before the start of the session.[4] Users can also use hydrogel pads.[6] In that case, the skin under the electrodes has to be clean in order to avoid injuries.[7]

Go Flow Sports also includes the sport cap and armband that holds electrodes on the head or the arm of users. The cap contains holes open to certain regions of the scalp that ensure a more precise placement of electrodes. The various placements of electrodes with regards to the expected outcome of the session is described in the Go Flow Sports booklet.[4]

The session begins with the moistening of electrodes. Then the electrodes are fastened to the head by the cap or the band. In cases when users intend to put the cathode on their arm and they own Go Flow Sports, they can fasten it by the armband. The cables are adjusted by magnets to the electrodes. Finally, cables are connected to the brain stimulator and the setting of the session is designed by the button. The manual for Go Flow Sports suggests four possible settings for the session: training longer, training harder, learning new skills and getting into the zone. There should be a 48 hour gap between each session, according to the manual.[4]

The title GoFlow was originally used for the device, which was developed as a prototype in 2012 by two students at the University of Michigan named Matt Sornson and Nick Woodhams.[5] Later, they supported the device that was developed by Foc.us.[8] In 2016, Foc.us developed a device that would be reliable and considerably cheap. They entitled it 'Go Flow' as the allusion of the previously mentioned project.[1]

Purpose

The main purpose of the device is to enhance the skills of its users through affordable and reliable tDCS devices. The specific ability that is enhanced depends on the placement of electrodes. Go Flow Sports focusses on the enhancement of motor skills.

Company & People

Go Flow is shipped by Transcranial Ltd., which is based in London, UK. The company is also referred as 'Foc.us'. It was founded by two engineers. They claim, however, that they cooperate with neuroscientist.[9]

  • Michael Oxley: Co-founder and CEO of Foc.us
  • Martin Skinner: Co-founder of Foc.us[9]

Important Dates

  • November 2015: Foc.us decided to build an accurate, reliable, and affordable tDCS device
  • January 2016: Focus Go Flow device was unveiled[1]
  • September 2016: Foc.us introduced Go Flow Sports[10]
  • October 2016: Go Flow Sports began shipping[11]

Enhancement/Therapy/Treatment

There is no indication of a precise purpose for Go Flow Pro, but the claim that Foc.us provides on their websites about DIY tDCS devices might hold. Namely, they argue that tDCS could enhance endurance, focus, and working memory. These enhancements are based on neuroplasticity.[12]

Go Flow Sports Cap

Go Flow Sports is intended as a device which enhance physical skills. The accompanying booklet describes several placements of electrodes that could enhance certain abilities.[4] The enhancement is described in more detail in Foc.us blog posts.[13][14][15] First, there is a treatment that should enhance implicit motor learning. The electrodes are placed at F3 (high on the left forehead) for cathode and at Fp2 (just above the right eye on the forehead) for anode.[16] This placement could be used by right-handers as well as left-handers. The session takes 15 minutes and the recommended current is 1.5 mA.[13] The design of the session and the output was suggested by research conducted by the University of Hong Kong. The different tDCS devices were used in the research.[17]

Second, the session could also be focussed on the length of training. In this case, the electrodes are placed on the left temple at T3 (anode) and the contralateral shoulder (cathode). The session should take 20 minutes, and the current should be 2 mA.[15] The design of the session is also based on a study.[18] Third, researchers claim that tDCS could help athletes train harder. This session takes 20 minutes with a 2mA output and electrodes placed on F3 (anode) and the contralateral shoulder (cathode). This setting is also inspired by research that was conducted previously.[19]

Although there are several studies that claim that tDCS improves the mental or motor skills of its users, there are also studies that question the efficacy of tDCS.[20]

Go Flow is not a medical device, and developers are quite cautious not to put any misleading claims on Go Flow's webpage. They argue:

tDCS can help increase your focus, working memory and endurance. These are the only benefits we recommend using tDCS for. If you have a medical condition you are hoping to treat you should not consider foc.us. If you have any medical questions we cannot help you, sorry.[12]

Consequently, the device is not regulated by the FDA. There is, however, Foc.us' motto 'take charge', which could be considered as a kind of medical claim.[5]

Ethical & Health Issues

There are several ethical and health issues that are linked to tDCS in general, and for both DIY tDCS and Go Flow.

In general, various problematic features of tDCS have been identified. First, there are still several issues linked with tDCS that remain as unknown long-term effects of tDCS. Second, the tDCS session is influenced by many factors such as gender, hormones, or handedness.[21] Third, the enhancement of a certain skill could be accompanied by the impairment of other skills.[22]

Beside these, there are also issues linked with DIY tDCS devices. The placement of electrodes is crucial for the output of the session, but the instructions that accompany tDCS devices tend to be insufficient.[21] There are several health and placement's information in Go Flow's booklet but they are by no means all-encompassing.[4] Further information is contained on the Foc.us blog; however, they claimed here that this information is based on third-party studies.[13][15] Several people who are involved in DIY tDCS are acquainted with the research,[23] but since the device is publicly available there is no guarantee that the consumer is sufficiently informed. However, among other DIY tDCS developers, Foc.us still provides a certain amount of information about the use of their device.

Similarly to Halo Sport, Go Flow Sports could be considered doping. However, tDCS devices have not been regulated neither by WADA (the World Anti-Doping Agency) nor by the International Olympic Committee as of yet. The involved organisations collect information about the technology of the moment.[24]

Another controversial aspect could be that authors use papers to support of their claims that were published in the journal Frontiers in Human Neuroscience.[19] The publisher house is in Beall's List of Publishers.[25][26]

Regarding radiation, Go Flow follows part 15 of the FCC rules. These rules focus on radiation exposure limits set forth for an uncontrolled environment.[4]

The manufacturers identify in the booklet several conditions that are contraindicated for the use of their device. Go Flow should not be used by people under the age of 18. People with epilepsy, seizures, brain lesions, bipolar depression, or severe heart disease should also avoid this device. The skin under the electrodes must not be damaged before use.[4]

The use of tDCS devices could be accompanied by certain side effects. Users could suffer skin burns, dizziness, or headaches.[12] There were reported injuries caused by sticky electrodes that were used in certain types of Go Flow devices:

Recently, we've seen an increased interest in using tDCS devices with sticky electrodes (primarily because this is one of the default configurations of the foc.us GoFlow device which launched recently). Coincident with this, we've seen an increase in reports of injuries from sticky electrodes.[7]

The skin could be also burned if the sponge electrodes are not wet enough.[4]

Public & Media Impact and Presentation

Athletes wearing Go Flow Sports

In general, Go Flow is appreciated by users. Brent Williams, who owns a blog Speak Wisdom, claims: 'The foc.us Go Flow is a great tDCS device – providing great capability at a very low price.'[27] The user 'Nigel' at 'Caputron tDCS Devices and tDCS Accessories' clams: 'If you are looking for a portable and powerful tDCS device look no further. This can easily fit anywhere and provides excellent features such as a timer and ramp up/down.'[28] In addition, among the manufactures producing tDCS devices, Foc.us provides a certain amount of information that is also approved by its users[29] even though some of them claim that information provided by Foc.us is not sufficient.[30]

Debaters of 'DIY tDCS' argue that Foc.us has to be extremely careful in their claim, in order to avoid FDA concerns. 'james katt' wrote: 'Focus obviously cannot state anything regarding medical conditions. That would bring the wrath of the FDA on them, causing them to be banned from the market.'[31] 'John' added: 'Agreed. Focus have been careful all along. As Anna Wexler points out in our interview, it’s a very wriggly line and in a state of flux at the FDA'.[32]

There were several complaints concerning the customer service of Foc.us. The user entitled 'johnsown' on Reddit claims:

Foc.us. is the worst company I have ever had anything to do with. My foc.us. bricked after about three months. Contacted customer service. Got no reply at all. Contacted Michael's? email. No response. Out 200 dollars. You might notice that I have had positive things to say about them previously, because I liked the product, but it's not much use as a paperweight. Absolutely no customer service as another poster said.[33]

The user 'raiden3600' had a similar experience, even though, in his case e-mailing the Foc.us CEO was successful:

When I emailed through their normal customer service address, I only got an automated response. I ended up emailing the more urgent email mike@foc.us and got a response back within 2 days. He was asking me what went wrong and to show him the results of what happened. I would try emailing that address and see how things go.[34]

Public Policy

The device is not regulated by FDA. The manufactures claim that it is not a medical device.[12]

Go Flow complies with FCC rules concerning radiation.[4]

Related Technologies, Projects, or Scientific Research

The development of Go Flow was based on research concerning tDCS. However, the manufactures are engineers and not neuroscientists.[9] They have not reported any independent research as of yet.

Since the Go Flow was shipped recently, it has not been widely discussed in ethical papers yet. Nonetheless, the issues mentioned in previously published papers still apply to it.[5][21]

References

  1. 1.0 1.1 1.2 1.3 1.4 OXLEY, Michael. The Story of Focus Go Flow. Foc.us Blog [online]. 2016, Jan 5. Available online at: https://www.foc.us/blog/the-story-of-focus-go-flow.html (Retrieved 14th November, 2016).
  2. 2.0 2.1 Foc.us. Hardware. Foc.us [online]. Available online at: http://eu.foc.us/all-products?SID=8ra4r8d2os79ll9iclduh9dmj7?SID=8ra4r8d2os79ll9iclduh9dmj7 (Retrieved 11th November, 2016).
  3. 3.0 3.1 Foc.us. Go Flow Pro - Stimulator, Cable, Sponge holders, Sponges & Headband. Foc.us [online]. Available online at: http://eu.foc.us/go-flow-pro-brain-stimulator (Retrieved 11th November, 2016).
  4. 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 4.11 4.12 4.13 4.14 4.15 Foc.us. Focus Go Flow Manual & Instruction Booklet. Foc.us [online]. Available online at: http://help.foc.us//article/38-focus-go-flow-manual-instruction-booklet (Retrieved 1st November, 2016).
  5. 5.0 5.1 5.2 5.3 5.4 WEXLER, Anna. A pragmatic analysis of the regulation of consumer transcranial direct current stimulation (TDCS) devices in the United States. Journal of Law and the Biosciences [online]. 2015, Oct 12. Available online at: http://jlb.oxfordjournals.org/content/2/3/669.full.pdf+html (Retrieved 1st November, 2016).
  6. 6.0 6.1 Foc.us. Go Flow Try tDCS - Stimulator, Cable & Pads. Foc.us [online]. Available online at: http://eu.foc.us/go-flow-try-me (Retrieved 15th November, 2016).
  7. 7.0 7.1 OHSNAPITSNATHAN. PSA: Sticky electrodes and skin burns. Reddit [online]. 2016, Jul 2. Available online at: https://www.reddit.com/r/tDCS/comments/4qx8ic/psa_sticky_electrodes_and_skin_burns/ (Retrieved 14th November, 2016).
  8. JOHN. News from GoFlow! Good and Bad. DIY tDCS [online] 2013, Jun 7. Available online at: http://www.diytdcs.com/2013/06/news-from-goflow-good-and-bad/ (Retrieved 1st November, 2016).
  9. 9.0 9.1 9.2 GEUSS, Megan. The gaming headset that (literally) shocks your brain to attention. Ars Technica [online]. 2013, May 19. Available online at: http://arstechnica.com/gaming/2013/05/the-gaming-headset-that-literally-shocks-your-brain-to-attention/ (Retrieved 15th November, 2016).
  10. OXLEY, Michael. Foc.us Launches tDCS Performance Enhancement for Pro and Amateur Athletes. Foc.us Blog [online]. 2016, Sep 21. Available online at: https://www.foc.us/blog/focus-launches-tdcs-performance-enhancement-for-pro-and-amateur-athletes.html (Retrieved 15th November, 2016).
  11. OXLEY, Michael. 1st October Update. Foc.us Blog [online]. 2016, Oct 1. Available online at: https://www.foc.us/blog/1st-october-update.html (Retrieved 16th November, 2016).
  12. 12.0 12.1 12.2 12.3 FOC.US. DIY tDCS. Foc.us [online]. Available online at: http://www.foc.us/diy-tdcs (Retrieved 16th November, 2016).
  13. 13.0 13.1 13.2 RAJESH. Last longer and train harder: Foc.us on endurance. Foc.us Blog [online]. 2016, Oct 10. Available online at: https://www.foc.us/blog/last-longer-and-train-harder-focus-on-endurance.html (Retrieved 16th November, 2016).
  14. OXLEY, Michael. tDCS Placements 10/20 Guide. Foc.us Blog [online]. 2016, Sep 1. Available online at: https://www.foc.us/blog/tdcs-placements-10-20-guide.html (Retrieved 16th November, 2016).
  15. 15.0 15.1 15.2 RAJESH. Achieve Sporting Prowess with Foc.us Brain Stimulation. Foc.us Blog [online]. 2016, Jul 25. Available online at: https://www.foc.us/blog/achieve-sporting-prowess-with-focus-brain-stimulation.html (Retrieved 16th November, 2016).
  16. WILLIAMS, Brent. The foc.us tDCS Headset, Review Part 4, Electrode Placements. Speak Wisdom [online]. Available online at: 2013, Aug 13. https://speakwisdom.wordpress.com/2013/08/31/the-foc-us-tdcs-headset-review-part-4-electrode-placements/ (Retrieved 23th April, 2017).
  17. ZHU, Frank P. et al. Cathodal Transcranial Direct Current Stimulation Over Left Dorsolateral Prefrontal Cortex Area Promotes Implicit Motor Learning in a Golf Putting Task. Brain Stimulation [online]. 2015, Mar 14. Available online at: http://dx.doi.org/10.1016/j.brs.2015.02.005 (Retrieved 16th November, 2016).
  18. OKANO, Alexandre Hideki et al. Brain stimulation modulates the autonomic nervous system, rating of perceived exertion and performance during maximal exercise. British Journal of Sports Medicine [online]. 2013, Feb 27. Doi:10.1136/bjsports-2012-091658 Available online at: http://bjsm.bmj.com/content/49/18/1213 (Retrieved 16th November, 2016).
  19. 19.0 19.1 AYACHE, Samar S. et al. Prefrontal tDCS Decreases Pain in Patients with Multiple Sclerosis. Frontiers in Neuroscience [online]. 2016, Apr 08. Doi:10.3389/fnins.2016.00147 Available online at: http://journal.frontiersin.org/article/10.3389/fnins.2016.00147/full (Retrieved 16th November, 2016).
  20. HORVATH, Jared Cooney et al. Quantitative Review Finds No Evidence of Cognitive Effects in Healthy Populations From Single-session Transcranial Direct Current Stimulation (tDCS). Brain Stimulation [online]. 2015, Jan 16. Doi: 10.1016/j.brs.2015.01.400. Available online at: http://www.brainstimjrnl.com/article/S1935-861X(15)00857-8/abstract (Retrieved 10th November, 2016).
  21. 21.0 21.1 21.2 WURZMAN, Rachel et al. An open letter concerning do-it-yourself users of transcranial direct current stimulation. Annals of Neurology [online]. 2016, Jul 7. Doi: 10.1002/ana.24689 Available online at: http://onlinelibrary.wiley.com/doi/10.1002/ana.24689/abstract (Retrieved 16th November, 2016).
  22. IUCULANO, Theresa; COHEN KADOSH, Roi. The Mental Cost of Cognitive Enhancement. J Neurosci 10 [online]. 2013, Mar 6. Available online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672974/ (Retrieved 1st November, 2016).
  23. WEXLER, Anna. The practices of do-it-yourself brain stimulation: implications for ethical considerations and regulatory proposals. Journal of Medical Ethics [online]. 2015, Aug 31. Doi: 10.1136/medethics-2015-102704 Available online at: http://jme.bmj.com/content/early/2015/08/30/medethics-2015-102704.abstract (Retrieved 18th November, 2016).
  24. BENNETTS, Julian. I got an electrical charge put straight into my brain to explore the bizarre new frontier of doping in sport. The Telegraph [online]. 2016, Aug 19. Available online at: http://www.telegraph.co.uk/olympics/2016/08/19/i-got-an-electrical-charge-put-straight-into-my-brain-to-explore/ (Retrieved 12th September, 2016).
  25. BEALL, Jeffrey. List Of Publishers: Potential, possible, or probable predatory scholarly open-access publishers. Scholarly Open Access [online]. Available online at: https://scholarlyoa.com/publishers/ (Retrieved 18th November, 2016).
  26. DVORSKY, George. No, Scientists Have Not Created a Matrix-Like Interface That Instantly Uploads Data to Your Brain. Gizmodo [online]. 2016, Mar 1. Available online at: http://gizmodo.com/no-scientists-have-not-created-a-matrix-like-interface-1762197710 (Retrieved 13th December, 2016).
  27. WILLIAMS, Brent. How to Pick the Right Stuff for the Go Flow tDCS Device. Speak Wisdom [online]. 2016, Mar 20. Available online at: https://speakwisdom.wordpress.com/2016/03/20/how-to-pick-the-right-stuff-for-the-go-flow-tdcs-device/ (Retrieved 18th November, 2016).
  28. NIGEL. Focus Go Flow Pro tDCS Device Starter Kit. Caputron tDCS Devices and tDCS Accessories [online]. Available online at: http://www.caputron.com/transcranial-electrical-stimulation/49-focus-go-flow-pro-tdcs-starter-kit.html#idTab5 (Retrieved 18th November, 2016).
  29. CURIOSITRY. Neurotech Hardware Roundup 2016. The Autodidacts [online]. 2016, Feb 21. Available online at: http://www.autodidacts.io/neurotech-hardware-roundup-eeg-bci-tdcs-neurofeedback/ (Retrieved 18th November, 2016).
  30. HIPERHIPER. first time trying go foc.us go flow pro - which wire is cathode / anode?. Reddit [online]. Available online at: https://www.reddit.com/r/tDCS/comments/50rngp/first_time_trying_go_focus_go_flow_pro_which_wire/ (Retrieved 18th November, 2016).
  31. JAMES KATT. Comments at: Focus Posts ‘Before You Get Started’ Page For DIYers. DIY tDCS [online]. 2016, May 27. Available online at: http://www.diytdcs.com/2016/05/focus-posts-before-you-get-started-page-for-diyers/#comments (Retrieved 18th November, 2016).
  32. JOHN. Comments at: Focus Posts ‘Before You Get Started’ Page For DIYers. DIY tDCS [online]. 2016, May 27. Available online at: http://www.diytdcs.com/2016/05/focus-posts-before-you-get-started-page-for-diyers/#comments (Retrieved 18th November, 2016).
  33. JOHNSOWN. foc.us Go Flow questions. Reddit [online]. Available online at: https://www.reddit.com/r/tDCS/comments/4ntfmn/focus_go_flow_questions/ (Retrieved 18th November, 2016).
  34. RAIDEN3600. Foc.us Go Flow; anyone else having issues with it?. Reddit [online]. Available online at: https://www.reddit.com/r/tDCS/comments/4aqjdx/focus_go_flow_anyone_else_having_issues_with_it/ (Retrieved 18th November, 2016).