NEW RESEARCH (Sept. 16, Nature)

I have just read it and read an article about the location.i think it correct. Areas around this location have been found to be larger in MRI scans and overactive in fMRI studies in depersonalisation. The location is a part of the "default mode network" or the network the brain is in when it is at rest and self reflective. The location is to deep in the brain to affect with rTMS but it like to be in several networks with locations you can affect with rTMS. The current french rTMS trail on "angular gyrus" is a central hub in the default mode network might have some affect on it in some. The medial prefrontal cortex and anterior cingulate are also overactive in depersonalization. They are also central hubs in the default mode network. So, the response from this location could likely be turned off by working with these locations in the default mode network. You need neuronavigation to find these location and a deep coil for the medial prefrontal cortex/dorsal nexus. A coil just approved for OCD in the US and likely later in Europa can work on this location also called the "dorsal nexus". It is a depression, OCD, PTSD location.

To this article is a 8.min video where stimulation at the dorso medial prefrontal cortex/dorsal Nexus is done with neuronavigation and the coil that just have been approved in the US that go stimulate deep enough.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692428/

It partly looks like that the "default mode network" is central in depersonalisation with areas that are active at rest/Sleep as very active. I will wait to the french "angular gyrus" trail is published. It is related to the area via the default mode network and might be affected by inhibition angular gyrus. The French trail should do some scannings after the trail and might look for differences in non-responders, partial and full responders. I think it will point towards locations in the prefrontal cortex that is related to the default mode network as the main reason for no or partial response. In no or partial responders the activity might be high in the prefrontal cortex to normalize the network. So, it might settle what location in the prefrontal cortex is central. It has been very confusing until now.

leminaseri said:

so if i understand your theory right, if they are able to figure out exactly which areas in our brain are responsible for dpdr, and if they found a coil whats able to go that deep, then we can treat our symptoms?

it sounds too easy for me, i dont know.

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The area that is found abnormal and making dissociation is a central hub, -likely the most central in the default mode network. Other areas related to the default mode network is also found affected and overactive in depersonalization like the medial prefrontal, anterior cingulate, angular gyrus, right TPJ. I think the medial prefrontal cortex is the second potent location in the network. The medial prefrontal is central in some depression, OCD and many with depersonalization had their outset with depression or had OCD like symptoms prior to the outset. There are many OCD like symptoms in depersonalization like constant checking and self monitoring. So, I think this location is central. But, it not easy to treat right now. You need a coil for deep rTMS to affect the medial prefrontal and you also need neuronavigation to find locations like angular gyrus and the medial prefrontal cortex. There are almost none in Europe that have both a deep coil and neuronavigation. You also need a location for some prices that is fair and can be paid.

Broken said:

The retrosplenial cortex seems a pretty fascinating area I hadn't really considered but seeing just basic info about it explains many symptoms of my individual DPD. Particularly episodic memory.. I have some form of dissociative amnesia. I just shut down when challenged, or embarrassed socially.

Dont know what this could hold, looks promising as a new idea though. Has made me consider trying Lamotrigine again. I know one person said they felt nothing for months once, then it was as if one day a lightbulb was switched on... Benzo's in small doses perhaps. Perhaps Clonazepam, although unlikely my GP will prescribe me that

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There is likely a difference between a drug induced retrosplenial response and when it likely is responding to a activity from locations it is in network with. We know that both the anterior cingulate and both sides of the dorsomedial prefrontal cortex is overactive in depersonalisation. They are in network with the location though the default mode network. So, it is likely in that response due to activity from other locations. It might explain that less 50% respond in trails with lamotrigine with a 35% reduction because the abnormal activity in locations like the anterior cingulate and the dorsomedial prefrontal cortex is still there.

it is also noteworthy that either lamotrigine or clonazepam as monotherapies have no effect but is combined with a antidepressant when there are seen a effect.

I think that psychiatrist, Ruth Lanitus who is a PTSD researcher did some brain scans in the midbrain in 2017 of a structure called the "periaqueductal gray" in the dissociative subtype of PTSD and found the ventral part of it active in the dissociation. The ventral part has been associated with freezing and immobilization in animals. This response was accounting to her made by a overactivity in the ventromedial prefrontal cortex. She said that there was a need for doing studies of deeper structures in the brain in relation to dissociation. Everything there is small and you need a powerful scanner to see the activity of so small structures like a 7.tesla scanner recently developed. We only have one of them in Denmark as they cost around 4.mill dollars and likely expensive to run on hourly basis. Only used for research. But, to make a study of deeper structures in depersonalization like the periaqueductal gray and retrosplenial area in depersonalization could be interesting . I think that a response in retrosplenial area is likely related to the ventral part of the periaqueductal gray. But, it will not change much in relation to treatment as they are so deep. There most be areas in the prefrontal cortex that turns these responses on that can be turn off with rTMS.