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#1 Markjones90

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Posted 11 April 2020 - 05:02 AM

I have engaged in many many binge drinking episodes over the last decade or so and began to suffer panic attacks during withdrawal as a result. Hypersensitive receptors? Maybe.

I developed HPPD with comorbid DP/DR in 2005 so have a feeling that all of the negative psychological symptoms are linked to this neurological disorder.

I have tried SSRIs which did naught to help my psychological problems whilst increasing my visual symptoms and am currently on lamictal (100mg) for five weeks which doesn't seem to be demonstrating much efficacy thus far.

I have been reading about the damage binge drinking can cause to our NMDA/R and am wondering if the NMDA/R might also be linked to my HPPD/DP/DR.

I also suffer from trichotillomania if that is relevant at all.

Would TMS be useful if the NMDA is implicated in what ails me? TMS on the PFC of perhaps another area of the brain?

I know positive thinking/acceptance/exercise etc. are very useful at helping on live with this conditions but really think I need the expertise of a neurologist/psychiatrist to truly make somewhat of a recovery from these disorders.

Thanks for all of your help and thank you for reading.

#2 Mayer-Gross

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Posted 12 April 2020 - 03:23 AM

" TMS on the PFC of perhaps another area of the brain?"

That is a nonsense statement. The prefrontal cortex is a large area of the brain with many structures involved in cognitive regulation of emotions. rTMS is typically given to the left or right dorsolateral prefrontal cortex as it is the only locations approved for rTMS and 95% of private providers of rTMS have the tools to locate and the coil to stimulate. Other areas you often need a MRI scan to find, rTMS equipment to calibrate the location and sometimes a special coil to do deep rTMS as the structure is too deep in the brain for a normal coil to reach. 95% of rTMS providers cannot do that. 

 

So almost all rTMS is done at the right or left dorsolateral prefrontal cortex (DLPFC)

There are other locations in the prefronal cortex of interest in various disorders like;

The left and right dorsomedial prefrontal cortex (DMPFC)

The left and right frontopolar cortex

The left and right ventromedial prefrontal cortex (VMPFC)

The left and right ventrolateral prefrontal cortex (VLPFC)

 

​From brain scannings of depersonalisation the right DLPFC is found overactive, both the left and right medial prefrontal cortex is found overactive and the right ventrolateral prefrontal cortex in some studies. You need a special coil to go into the medial prefrontal cortex that can go 4-6.cm into the brain. It is has never been tried. 

 

http://dribrahimyilm...emik-Makale.pdf



#3 RunToMe

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Posted 12 April 2020 - 03:37 AM

Hey Dino,

 

as you know i did rtms in utrecht. The psychologist made 10 seizures at one second at right dlpfc.Makes it the condition worser due to the researchers outcomes that right dlpfc is overactive.

 

And have you done anything yet in the field of rtms or you planning something right now ?



#4 Markjones90

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Posted 12 April 2020 - 03:44 AM

Thanks very much for clearing up my misconceptions Mayer-Gross. Demonstrating my ignorance for all to see seemingly.

I am very interested in pursuing TMS and just wanted to know as much info re. the procedure from an unbiased source as realistically, it's a one shot deal considering the cost of the procedures.

I did read about TMS being used on the TPJ as well. Is that viable?

#5 RunToMe

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Posted 12 April 2020 - 04:04 AM

Hi Mark-Jones,

 

where you are from ?

 

I made it in Netherlands. They do it without neuronavigation. Its relative cheap there. i paid to each session 100 euro. i made daily 1 in 14 days. When you want i can give you further information.



#6 Mayer-Gross

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Posted 12 April 2020 - 04:12 AM

To, "Runtome"

I have many difficulties given you advice. Here is my problem;

 

1)I suffer from depersonalisation disorder in it primary form. The outset for this disorder is typically between 15-25 of age for 90%. The majority of the 10% develop the disorder prior to that age. You are twice the age of the median age for the outset. 

2) You have been seen by a prof. in your country who have written books and publications about depersonalisation disorder. He have said to you that you don´t suffer from depersonalisation disorder in its primary from but major depression with secondary symptoms of depersonalisation. When you suffer from that the symptoms of depersonalisation should subside with the depression. 

3) your compliant on this site is symptoms like anhedonia, inability to sleep, lack of appetite. These are all symptoms of major depression. Not, depersonalisation disorder. 

 

So, why are you insisting of getting a treatment for depersonalisation disorder when you likely do not suffer from the condition?

 

I have tried rTMS at the right VLPFC and the right TPJ from a MRI scan a month ago with another one. None of us have benefited from it. Some research from germany and also research into the dissociative subtype of PTSD that also sufferes from depersonalisation point towards the right medial prefrontal cortex as the site for making the emotional suppression in depersonalisation. It is also a location of interest in depression. The problem is that this site is very deep into the brain. There is a lot a cranial bone and tissue from a brain location in front of it that a normal rTMS cannot reach it. You need a special coil for deep rTMS that can go 5-6.cm deep. The coil is relatively new and i do not know of any private providers of rTMS who have it. The coil looks like this.https://www.magventu...oils/cool-d-b80



#7 Mayer-Gross

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Posted 12 April 2020 - 04:25 AM

This german diffusion tensor imaging study into depersonalisation from 2018 found indications that emotional numbing in depersonalisation came from the right ventromedial prefronal cortex overactivity.https://www.ncbi.nlm...les/PMC6158023/



#8 RunToMe

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Posted 12 April 2020 - 04:32 AM

Thanks you a lot !

 

Sorry, for insisting. its my despair owed.



#9 Mayer-Gross

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Posted 12 April 2020 - 05:11 AM

Thanks you a lot !

 

Sorry, for insisting. its my despair owed.

You could try other locations for major depression. The site that is active in in depersonalisation is also a depression site but need a special coil for rTMS. The location is used in depression with anhedonia and 50% that don´t respond to rTMS at the right or left DLPFC respond to this site. There is only one place in Europe that have such a coil. I know them and they where open to me at first but didn't reply  me after. They likely will not go into depersonalisation disorder at all because research and trial are very small. So, if i gave you their address and you started with your hallmark idiocy -" i suffer from depersonalisation". They would likely turn you down. The prognosis for major depression and treatment options  are many compared to depersonalisation and you are suffering from that but continue to claim you are suffering from depersonalisation. It is like you will not be normal and try the options you have by claiming you are suffering from depersonalisation with writing on this site about symptoms related to major depression.  

 

You could also try deep rTMS for major depression with machines from "Brainwave". But, everything is closed down right now in Europe and there is no point in it right now. You can use that time to stop calling your state depersonalisation disorder when it is major depression. Here is a trail and the location i think might benefit you.https://www.ncbi.nlm...pubmed/29153927



#10 RunToMe

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Posted 12 April 2020 - 05:17 AM

Thank you, you are so engaged in rtms and the best expert in this topic !



#11 Mayer-Gross

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Posted 12 April 2020 - 05:36 AM

Thank you, you are so engaged in rtms and the best expert in this topic !

Yes, i likely am. I read all brain imaging studies into depersonalisation, much research into rTMS in general. 

 

PS. The depression trail with rTMS at the right orbital prefrontal cortex at 1.hz is the same as the right ventromedial prefrontal cortex. The right orbital prefrontal cortex and the right ventral medial prefrontal cortex are the same area,- just two diffrent terms. This area is also overactive in almost all brain imaging studies of emotional numbing in depersonalisation. It have connection to immobilisation when the body and brain can not mobilised a "fight and flight response"- it shot down.. The body becomes very parasympathetic by its overactivity.   https://www.ncbi.nlm...les/PMC2590602/



#12 Markjones90

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Posted 12 April 2020 - 08:29 AM

Hi Mayer Gross. Some excellent insights there. Thank you so much.

My DP/DR was prompted by a drug episode many moons ago with concurrent visual symptoms (trails, halos around objects etc.)

I have developed depressive episodes since then but I think the DP has promoted the depressive episodes rather than vice versa.

Based on your research and expertise, do you think I am wasting my time with TMS on the right VLPFC and TPJ or do you think if might still be worth a shot?

How useful is a MRI/QEEG/neuromodulating in investigating the area of the brain which gives the greatest prospect of success?

Thank you so much once again. I think this thread could turn out to be an invaluable source of info for people for years to come.




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