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WithYourSigh

Member Since 25 Nov 2012
Offline Last Active Today, 09:02 AM
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Posts I've Made

In Topic: Development of more advanced rTMS equipment.

11 December 2020 - 09:03 AM

Thank you for the wealth of information. Please keep updating with new information in case you are treated with rTMS again. Treatment of any kind is irrelevant for me at the moment, but I may look into it again in the future.


In Topic: Development of more advanced rTMS equipment.

10 December 2020 - 10:39 AM

so this means it doesnt matter how much or deep of the vlpfc you do stimulate. if someone with dpd doesnt respond to any stimulation, then he seems to be refractory to any treatment.

another thing is, if they would develop a coil or a machine whats able to stimulate very deep areas in the brain, then they should be able to treat any psychoneurogical illness. but im sure, the reality is not like this. the pure psychological aspects are very important.

for example, if someone has the dpd due to huge anxiety and panic, and the brain triggered the depersonalization to suppress those horrendous feelings, then if you trick the brain to come out of the dissociation, you should get those horrible anxiety and panic again, what would end in an endless cycle.

 

Please note that the region of my brain which received dTMS is the DLPFC, implicated in depression, as opposed to the VLPFC, implicated in DP, therefore no conclusion could be drawn as to the nature of my disorder. I responded partially to Lamictal, with which I am no longer treated, and to various supplements. As for the rest of your comment, when TMS is considered successful in a patient, they may still develop the same symptoms after a period of time; it is surely not considered to be permanent cure.

 

On this site most of them who have tried rTMS have been without neuronavigation. Having read much brain imagening into depersonalisation and rTMS is general i would say that it is impossible to find these location without neuronavigation. I have had some correspondence with one in the UK who might come out with a book about depersonalization and he says that he have traced about 21.people who have tried rTMS at the “smart TMS” in the UK without effect. But, “smart tms” is a very expensive and ill equipped rTMS chain in the UK who do not have neuronavigation. So, I will consider all these attempts totally worthless due to the locations only. 

 

The right VLPFC might not have any role in depression. “Brainsway” have tried other locations for different conditions without effect they have published them and if she claims she have done several trail without effect and not made a publication I would say something is wrong. You can not use such a claim to anything. Why have she not made a publication? Have she tried in depersonalization or depression? If is in depression then this information is also worthless as the emotional regulation in depersonalization and depression is not the same. The left and right DLPFC works in 50% with depression and allmost none in depersonalization because the emotional regulation are not related. 
 

The right VLPFC might be wrong but you can say it as so few have tried this location with neuronavigation and a normal butterfly coil can only stimulate 30% of this location. I have tried for 12.session and I don’t know if the location is wrong as it is only 30% that have been stimulated. It could also be the anterior cingulate and the dorsomedial prefrontal cortex. Again you need a deep coil for this locations. 

 

As I said previously, admittedly, the particular details of the various studies of TMS for DP patients are no longer fresh in my mind. Naturally, it seems that you are well read in this topic, but several questions come to mind. If am not mistaken, neuronavigation was used in those studies where TMS was given to either the TPJ to VLPFC (Mantovani et al., etc.), and the results were impressive. As for the author you mentioned, while those 21 individuals were treated unsuccessfully, do we know how many were treated successfully? Were they all suffering from DP? You may be familiar with Elliott (alias Elliott King), who was active in the DP community several years ago and seems to have vanished. I remember vaguely that, as a person trained in neuroscience, he collaborated with Smart Clinic and conducted a study with them on TMS to either the TPJ or VLPFC. He said that a person who was treated as part of the study achieved complete remission and maintained it a year later, and also that the study should be published soon. Then, he vanished. I believe Elliott was a believer in TMS to these regions for DP patients as much as the research allows us to be, and wanted to promote further research. Naturally, I regard his opinion more than my own.

 

I do not know the specifics of said researcher, nor do I know whether it was published or not. I was not in a position to inquire. I would say that she seemed to insinuate that various disorders were at the center of her research, but DP was likely not one of them. It is mostly DP experts who research the disorder, and the researcher with which I spoke is certainly not one.

 

I am sorry to hear that your experience with TMS was unsuccessful, quite as mine was.

 

 

WithYourSigh

 

if you live in Israel and is it easy to come to a Brainsway with a OCD coil that can stimulate the anterior cingulate and the dorsomedial prefrontal cortex I think you should consider it. There are some indication in some brain imaging studies of a overactivity in the anterior cingulate and the dorsomedial prefrontal cortex in depersonalization that is very OCD like. A brain imaging picture can be seen here, https://www.frontier...-00432-g002.jpg

 

it is from this study. https://www.frontier...2016.00432/full

 

Thank you for the information. There are several TMS clinics in Israel, at least one is private but run by a psychiatrist who conducts research, and is therefore knowledgeable. At this time, this information looks too preliminary to me. I would only consider TMS to either the TPJ or VLPFC; and, as you say, it may only be worthwhile with neuronavigation, which is not offered by private clinics. To me, It seems worthwhile only in the exact same conditions of the TPJ/VLPFC studies, although I certainly need to re-read them. It is possible only some of them used neuronavigation.


In Topic: Development of more advanced rTMS equipment.

09 December 2020 - 05:18 AM

I was treated in the past with TMS to the left DLPFC with no significant results. I no longer remember the particular details of the various testimonials found on DPSH, except that the patients themselves did the utmost to ensure that treatment is performed on either the TPJ or VLPFC, although this naturally does not provide any guarantee.

 

In light of this discussion, I located a correspondence between myself and a head researcher who conducted at the time dTMS research within an Israeli public mental-health center. She confirmed that the Brainsway deep coil is unable to reach the TPJ, but added that she had conducted several clinical studies using dTMS to the VLPFC with no significant results.


In Topic: Development of more advanced rTMS equipment.

09 December 2020 - 03:39 AM

Thank you for sharing the information. You may like to know that, since a coil for dTMS is manufactured by an Israeli company, the majority of TMS clinics in the country, be they research units or private-practice units, perform dTMS.

 

As for the high response rate reported in the literature and by TMS clinics in the context of DP, I searched DPSH extensively in the past for testimonials of DP sufferers treated with TMS to either the TPJ or VLPFC and found a lack of correlation between the reported response rate and the first-hand experience of those who received the treatment.