I participated in a 4 week rTMS study clinical earlier this summer, for treatment-resistant depression. Study included:
- ~30 minute sessions, 5x a week
- rTMS device stimulates the prefrontal cortex (located through an MRI, and located each session with a pre-measured cap that you wear during the session)
- rTMS is non-intrusive, and seems to have virtually no side effects (unless you have a history of epilepsy, which would have precluded you from the study)
I would describe the sessions as pain-free, with a sense of mild annoyance (the magnetic pulse feels like someone flicking you on the head with a finger). Some other people experienced headaches the first two weeks during treatment, but I didn't experience that.
In terms of effectiveness, I would say that it helped greatly reduce the symptoms of depression for me. I've struggled with depression for ~10 years, and antidepressants would sometimes help, but the side-effects were just not maintainable. With rTMS, I feel like it reduced my symptoms by about 60% (not completely gone, but man can I ever function in life again!).
It's been about 3 months since I participated in the trial, and I am now participating in their maintenance program (2 sessions a month, ~10 minutes per session). At this point, I'm recommending rTMS for those who haven't been able to find anything that works for them yet.
I had rTMS done for a few months, and a couple of different protocols of ketamine infusions.
rTMS was mostly just killing time after I got used to the noise and sensation - the doctor I saw had a TV mounted with Netflix and other services available for you while you sat there.
Ketamine (IV; I haven't tried the esketamine nasal spray that got approved) is an intense experience each time - many doctors advise people sit in dark rooms with headphones playing music while the treatment goes on. I usually describe it as removing a lot of the ability to ignore things - that is, you experience a cognitive burden for all the things you're seeing/hearing/etc in the room, and sufficiently much cognitive burden is draining. It also affects your flow of thought a lot so you don't necessarily track well in conversations with people until you're more experienced. (I also found that it made my emotions very directly influencible by the music or conversation or w/e was going on during the treatment.)
It often makes people nauseous or vomit, so every clinic I've been to stocks an anti-emetic and a bucket.
Some doctors also give you a benzo with the ketamine because it makes it a less intense experience. There's inconclusive research on whether this dulls the antidepressant effect last I looked - I requested during my most recent treatments (mid-late 2018) that they not use it, and they were happy to comply, but it definitely makes the experience less visceral.
rTMS I saw no personal benefit from even after extending the treatment interval past the usual number of weeks. Ketamine I saw massive improvement a month or so after doing an initial treatment of 6 infusions in 2 weeks, but after a few weeks the effect lapsed (though I'd been having "maintenance treatments" periodically), with no recurrence regardless of the protocol we tried.
Please feel free to ask if there's some specific questions that'd be useful to have answered.
There is a female MMA fighter, Cat Zingano, who is vocal about her Repetitive transcranial magnetic stimulation (rTMS) treatments. She did a Joe Rogan podcast and spoke about it very positively. Very anecdotal but very interesting.
Will be interesting to hear her perspective, but like an above poster mentioned it doesn't amount to much.
Couple that with the fact that athletes notoriously buy into 'woo' treatments (not to mention Joe Rogan himself is notoriously into 'woo') and it's unsurprising that she may rave about it.
Just to give a few things I've heard fighters 'rave' about in the past that have little to no substantive effect on performance:
- Crossfit and 'functional' fitness at large
- Cryo dunking themselves after a workout
- Elevation masks
- Bulletproof coffee
- CBD (not saying there aren't effects but the range of health claims made border on the absurd)
- Eating a Vegan diet vs a Paleo diet vs a Keto diet...
- Movement(?) training
- Acupuncture
- Cupping
The list is almost endless. Athletes are always looking for an edge, and many of them (much like the general populace) are not well equipped to separate the woo from the goo.
One thing that struck me was that her rTMS I think was for concussive syndrome/symptoms. Whereas I thought rTMS was primarily marketed for depression and anxiety (seems some of the other posters here have personally tried rTMS for depression). Her personal story includes the tragedy of her husband committing suicide leaving her behind with their young daughter, so maybe she also has/had some depression issues and was seeing benefits with respect to that...anyway give the podcast a listen, she is an interesting person anyway.
I've received tDCS (transcranial direct current stimulation) for the better part of 2 years following a significant traumatic brain injury. It has hastened my recovery by months/years due to the stimulation and brain training. Many times I would feel completely exhausted following the stimulation (and bleeding edge neurofeedback training). It is an amazing tool that is coming into mainstream.
A kinder response would be to ask brainstim01 how they know -- whether they are comparing against typical cases. Or are you expressing skepticism because, in principle, something so unique as traumatic brain injury is always unique and can't be double-blinded?
Not trying to be mean or make a point about this particular treatment. Just stating a fact that it's essentially impossible for an individual to know what treatments worked and didn't work. This is how we end up with woo and traditional Chinese medicine and crystals.
I have no idea about this particular treatment, but I know that the only way to get an idea is rigorous double blind testing.
>ask brainstim01 how they know
That's an unanswerable question. He can't know. There is no way to know if an individual treatment worked for you in the absence of a control group. (Ignoring placebos which, sure, can and do "work")
> [brainstim01:] No, but they asked for anecdotal data, and comparing how I progressed for the first year following the TBI versus the 2 years of brain stimulation and neurofeedback I am acutely aware of how much it helped.
I think observing a single individual in both untreated and treated time intervals provides some amount of control. It's not a terribly strong control, of course; one can certainly imagine scenarios such as that they were recovering the whole time, but that recovery hadn't reached a point where the effects became noticeable until the point where they happened to start the tDCS. So in the strong sense of "know", you're correct: they can't know for sure.
But to say that it provides no information at all is also wrong. The posterior probability that the treatment was helpful is greater, given these observations both before and after treatment was started, than if, for example, treatment had been started immediately. How much greater is hard to quantify, but a very substantial observed improvement suggests a significant effect.
I think I agree with everything here. I'm not saying no useful information can be derived. However the risk of the placebo effect or just general healing are hard to rule out on the limited information here. (Maybe OP's brain injury was slowly healing for a year but cognition gains didn't manifest until year two. I don't study brain health and we don't really have any information to make a judgement.)
The whole process has been frustratingly slow. To give some reference:
The cognitive recovery was not linear. For the first 6 months I couldn't consume any content. No TV, no music, no internet news. Either the stimulation was overwhelming and/or I couldn't process the information I was receiving. After 14 months I couldn't watch any TV show that was new content, only things I have seen before many times (Simpsons, South Park, etc). After 24 months I could start reading but memory and recall were still very poor. 36 months after I'm able to read and watch new content with moderately successful retention.
This is actually a fairly standard way to design a clinical trial, called the "stepped wedge" design.
Everybody gets the control arm, followed by the treatment, but the time of the switchover is randomized, often in steps (hence the name). If people consistently recover at the same time relative to the treatment, but at different absolute times, then you can conclude the treatment works well.
No, but they asked for anecdotal data, and comparing how I progressed for the first year following the TBI versus the 2 years of brain stimulation and neurofeedback I am acutely aware of how much it helped.
I've long been interested in this area, but your brain is not something you experiment with willy-nilly: if you do damage, it's not like bricking your raspberry-pi while trying some cool things. That's why direct electrical or magnetic stimulation sound scary to me.
The power at which tDCS is operated at is pretty low, after you account for resistance the voltage seems less scary. For me I get tDCS at ~13-17hz, 60hz, and 160hz at 0.5 to 1.75 milliamp. The different hz frequencies are to target different brain waves, (alpha, beta, delta, gamma, etc)
If you think it's still strong enough to affect brain function, I don't really see how the power being "pretty low" really makes things less scary. I mean, I guess you won't get electrocuted but messing up your brain is messing up your brain, regardless of how much power you used to do it.
>If you think it's still strong enough to affect brain function, I don't really see how the power being "pretty low" really makes things less scary.
Drinking a cup of coffee is "still strong enough to affect brain function", and yet we do it every day. In fact several times...
Using electricity that's "still strong enough to affect brain function", but small to have any major effect (they've tried this thing tons of times in clinical settings) is not that different...
> Drinking a cup of coffee is "still strong enough to affect brain function", and yet we do it every day. In fact several times...
Yes, the crucial difference being that you are not exactly breaking scientific ground by sipping a cup of coffee. The effects coffee has on our brain and body, both short and long term, are well researched and sufficiently tested.
Perhaps if it was poorly managed, scoped out, and they blasted the brain with unhealthy amperage of course. In my experience getting full brain scans frequently helps the doctors understand what the brain needs and tDCS supplements the brain.
The electric fields produced by tDCS aren't strong enough to force neurons to fire, even in brain areas very close to the surface/electrode, though they can adjust the timing of neural activity, so that cells fire slightly sooner/later than they might otherwise. My collaborators and I have collected some nice data from awake, behaving monkeys (which have obvious similarities to humans) demonstrating this.
"Popular electric brain stimulation method used to boost brainpower is detrimental to IQ scores"
> Using a weak electric current in an attempt to boost brainpower or treat conditions has become popular among scientists and do-it-yourselfers, but a new study shows that using the most common form of electric brain stimulation had a statistically significant detrimental effect on IQ scores.
Recently, a guy I know who is a chiropractor has been telling me how much he loves PEMF devices. He got one to use on his patients and said that a lot of pro athletes are using PEMF devices to speed up recovery from injury or just regular exertion. There are other benefits as well, according to him.
What I found really interesting was not the stated usage about increased bloodflow and other things from these electromagnetic pulses, but when he told me that being the curious individual he was the first thing he did with it was to wrap it around his head to see what would happen. He said he mind was racing and he felt like his brain was running at twice the normal pace. He said there was so much going through his head he couldn't stop talking. The effects wear off but it got me wondering if that's a sort of body hack one could do to maximize their work performance, albeit on a lower pulse strength so you're not pissing everyone off yapping all day.
38 comments
[ 3.0 ms ] story [ 88.9 ms ] thread- ~30 minute sessions, 5x a week
- rTMS device stimulates the prefrontal cortex (located through an MRI, and located each session with a pre-measured cap that you wear during the session)
- rTMS is non-intrusive, and seems to have virtually no side effects (unless you have a history of epilepsy, which would have precluded you from the study)
I would describe the sessions as pain-free, with a sense of mild annoyance (the magnetic pulse feels like someone flicking you on the head with a finger). Some other people experienced headaches the first two weeks during treatment, but I didn't experience that.
In terms of effectiveness, I would say that it helped greatly reduce the symptoms of depression for me. I've struggled with depression for ~10 years, and antidepressants would sometimes help, but the side-effects were just not maintainable. With rTMS, I feel like it reduced my symptoms by about 60% (not completely gone, but man can I ever function in life again!).
It's been about 3 months since I participated in the trial, and I am now participating in their maintenance program (2 sessions a month, ~10 minutes per session). At this point, I'm recommending rTMS for those who haven't been able to find anything that works for them yet.
I had rTMS done for a few months, and a couple of different protocols of ketamine infusions.
rTMS was mostly just killing time after I got used to the noise and sensation - the doctor I saw had a TV mounted with Netflix and other services available for you while you sat there.
Ketamine (IV; I haven't tried the esketamine nasal spray that got approved) is an intense experience each time - many doctors advise people sit in dark rooms with headphones playing music while the treatment goes on. I usually describe it as removing a lot of the ability to ignore things - that is, you experience a cognitive burden for all the things you're seeing/hearing/etc in the room, and sufficiently much cognitive burden is draining. It also affects your flow of thought a lot so you don't necessarily track well in conversations with people until you're more experienced. (I also found that it made my emotions very directly influencible by the music or conversation or w/e was going on during the treatment.)
It often makes people nauseous or vomit, so every clinic I've been to stocks an anti-emetic and a bucket.
Some doctors also give you a benzo with the ketamine because it makes it a less intense experience. There's inconclusive research on whether this dulls the antidepressant effect last I looked - I requested during my most recent treatments (mid-late 2018) that they not use it, and they were happy to comply, but it definitely makes the experience less visceral.
rTMS I saw no personal benefit from even after extending the treatment interval past the usual number of weeks. Ketamine I saw massive improvement a month or so after doing an initial treatment of 6 infusions in 2 weeks, but after a few weeks the effect lapsed (though I'd been having "maintenance treatments" periodically), with no recurrence regardless of the protocol we tried.
Please feel free to ask if there's some specific questions that'd be useful to have answered.
Couple that with the fact that athletes notoriously buy into 'woo' treatments (not to mention Joe Rogan himself is notoriously into 'woo') and it's unsurprising that she may rave about it.
Just to give a few things I've heard fighters 'rave' about in the past that have little to no substantive effect on performance: - Crossfit and 'functional' fitness at large - Cryo dunking themselves after a workout - Elevation masks - Bulletproof coffee - CBD (not saying there aren't effects but the range of health claims made border on the absurd) - Eating a Vegan diet vs a Paleo diet vs a Keto diet... - Movement(?) training - Acupuncture - Cupping
The list is almost endless. Athletes are always looking for an edge, and many of them (much like the general populace) are not well equipped to separate the woo from the goo.
One thing that struck me was that her rTMS I think was for concussive syndrome/symptoms. Whereas I thought rTMS was primarily marketed for depression and anxiety (seems some of the other posters here have personally tried rTMS for depression). Her personal story includes the tragedy of her husband committing suicide leaving her behind with their young daughter, so maybe she also has/had some depression issues and was seeing benefits with respect to that...anyway give the podcast a listen, she is an interesting person anyway.
Edit: For the equipment, more info can be found here: http://neurofieldneurotherapy.com/transcranial-direct-curren...
I have no idea about this particular treatment, but I know that the only way to get an idea is rigorous double blind testing.
>ask brainstim01 how they know
That's an unanswerable question. He can't know. There is no way to know if an individual treatment worked for you in the absence of a control group. (Ignoring placebos which, sure, can and do "work")
I think observing a single individual in both untreated and treated time intervals provides some amount of control. It's not a terribly strong control, of course; one can certainly imagine scenarios such as that they were recovering the whole time, but that recovery hadn't reached a point where the effects became noticeable until the point where they happened to start the tDCS. So in the strong sense of "know", you're correct: they can't know for sure.
But to say that it provides no information at all is also wrong. The posterior probability that the treatment was helpful is greater, given these observations both before and after treatment was started, than if, for example, treatment had been started immediately. How much greater is hard to quantify, but a very substantial observed improvement suggests a significant effect.
Everybody gets the control arm, followed by the treatment, but the time of the switchover is randomized, often in steps (hence the name). If people consistently recover at the same time relative to the treatment, but at different absolute times, then you can conclude the treatment works well.
However, there are other ways to experiment! I think the most amenable one is the Dream Machine (https://en.wikipedia.org/wiki/Dreamachine) or the Mind Machine (https://makezine.com/2008/11/13/the-brain-machine/ also https://learn.adafruit.com/brain-machine/overview).
Also related: https://news.ycombinator.com/item?id=21152542
Drinking a cup of coffee is "still strong enough to affect brain function", and yet we do it every day. In fact several times...
Using electricity that's "still strong enough to affect brain function", but small to have any major effect (they've tried this thing tons of times in clinical settings) is not that different...
Yes, the crucial difference being that you are not exactly breaking scientific ground by sipping a cup of coffee. The effects coffee has on our brain and body, both short and long term, are well researched and sufficiently tested.
The electric fields produced by tDCS aren't strong enough to force neurons to fire, even in brain areas very close to the surface/electrode, though they can adjust the timing of neural activity, so that cells fire slightly sooner/later than they might otherwise. My collaborators and I have collected some nice data from awake, behaving monkeys (which have obvious similarities to humans) demonstrating this.
- DC + behavior: http://packlab.mcgill.ca/Krause%20et%20al%202017.pdf - AC + deeper structures: http://packlab.mcgill.ca/Krause%20et%20al%202019.pdf
There's also a recent preprint replicating our AC results: https://www.biorxiv.org/content/biorxiv/early/2019/07/09/696...
"Popular electric brain stimulation method used to boost brainpower is detrimental to IQ scores"
> Using a weak electric current in an attempt to boost brainpower or treat conditions has become popular among scientists and do-it-yourselfers, but a new study shows that using the most common form of electric brain stimulation had a statistically significant detrimental effect on IQ scores.
https://www.sciencedaily.com/releases/2015/05/150505152140.h...
Argh — science journalists :-(
What I found really interesting was not the stated usage about increased bloodflow and other things from these electromagnetic pulses, but when he told me that being the curious individual he was the first thing he did with it was to wrap it around his head to see what would happen. He said he mind was racing and he felt like his brain was running at twice the normal pace. He said there was so much going through his head he couldn't stop talking. The effects wear off but it got me wondering if that's a sort of body hack one could do to maximize their work performance, albeit on a lower pulse strength so you're not pissing everyone off yapping all day.
You only live once, you only have one brain. Please be careful with Snake Oil until really proven by science...
Sorry, couldn't resist.. :-D