substantive material re tDCS and "brain fog" [moved from other thread]
 

It occurs to me that the bulk of the materiel I posted in my reply to Vrae in the memory loss and confusion in crps thread belongs here, so I'm cutting it out of that post and am instead putting in a link top this one.

Picking up with the feasibility and relative lack of financial burden in using anodal tDCS applied to the dorsolateral prefrontal cortex as a treatment for CRPS induced cognitive impairment:

. . . You could easily get set up with everything you need by way of equipment for just under $400 and with a pain doc/psychiatrist prescribing a brief starting course of Seromycin, along with maybe a weekly booster thereafter (and perhaps one or two other psycho-pharmacologic meds for good measure) there's an excellent chance of controlling at least the cognitive side-effects of your CRPS.

But before I launch too far into the specifics of the medical literature in hopes of encouraging your further exploration of the subject, here's some information of a more general nature that I didn't share above.

First of all, you should be aware that the most important site in the country (world?) for tDCS research is that of the Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, in Boston, MA. And the names of two of its principals, who are among the most respected neuroscientists in the country/world, keep popping up a lot in the literature: Alvaro Pascual-Leone and Felipe Fregni. And there's an incredible amount of valuable information on that site. And then, for something completely different, you may want to check out a quick over-view on the impact on a reporter’s immediate sense of a shift in her conscious awareness - specifically dramatically improved concentration and the cessation of internal chatter - Better Living Through Electrochemistry, Sally Adee, Feb. 9, 2012, The Last Word On Nothing.

That out of the way, and to get on with it, from just the freely available "open access" but peer reviewed literature, and by way of example, I offer the following:

Enhancement of planning ability by transcranial direct current stimulation, Dockery CA, Hueckel-Weng R, Birbaumer N, Plewnia C, J Neurosci. 2009 Jun 3;29(22):7271-7;

Transcranial direct current stimulation augments perceptual sensitivity and 24-hour retention in a complex threat detection task, Falcone B, Coffman BA, Clark VP, Parasuraman R, PLoS One 2012; 7(4):e34993 Epub 2012 Apr 12;

Task-specific effects of tDCS-induced cortical excitability changes on cognitive and motor sequence set shifting performance, Leite J, Carvalho S, Fregni F, Gonçalves ÓF, PLoS One 2011;6(9):e24140 Epub 2011 Sep 1;

Facilitate insight by non-invasive brain stimulation - A commentary on Enhancement of planning ability by transcranial direct current stimulation, Chi RP, Snyder AW, PLoS One 2011 Feb 2;6(2):e16655;

Manipulating executive function with transcranial direct current stimulation - A commentary on Enhancement of planning ability by transcranial direct current stimulation, Smith DV, Clithero JA, Front Integr Neurosci. 2009 Oct 8;3:26;

Improved proper name recall in aging after electrical stimulation of the anterior temporal lobes, Ross LA, McCoy D, Coslett HB, Olson IR, Wolk DA, Front Aging Neurosci. 2011;3:16. Epub 2011 Oct 12;

Polarity-dependent transcranial direct current stimulation effects on central auditory processing, Ladeira A, Fregni F, Campanhã C, Valasek CA, De Ridder D, Brunoni AR, Boggio PS, PLoS One. 2011;6(9):e25399. Epub 2011 Sep 23.; and

Transcranial direct current stimulation of the prefrontal cortex modulates working memory performance: combined behavioural and electrophysiological evidence, Zaehle T, Sandmann P, Thorne JD, Jäncke L, Herrmann CS, BMC Neurosci. 2011 Jan 6;12:2.

Finally, here's one on the concurrent use of Seromycin (cycloserine):

Consolidation of human motor cortical neuroplasticity by D-cycloserine, Nitsche MA, Jaussi W, Liebetanz D, Lang N, Tergau F, Paulus W, Neuropsychopharmacology. 2004 Aug; 29(8):1573-8.

I hope these materials will be of greater value in a new home: to the extent I'm not repeating myself. (And in that case, my apologies.)

Mike

tDCS device out, CRPS in [redux]
 

For the third time in six months, my Activa Dose II Controller Ionto device failed on me Sunday night, probably because I'm pushing the envelope just a bit, although not as aggressively as before: now using 2 mA for anodal stimulation of dorsolateral prefrontal cortex @ "F3" and 3 mA directed towards the dominant motor cortex @ "M1," both for 30 min./day. (With "lower extremity" pain, I was advised from the start not to expect too much in terms of pain control, and that about sums it up.)

As I've previously mentioned, the stimulation @ M1 worked wonders for my symptoms of "sympathetic dysrhythmia," primarily edema and myocardial small vessel constriction that not only had ceased to respond to nitroglycerin but had shown up for the last 2 years running in nuclear MRI blood profusion studies, while the treatment @ F3 was doing wonders for my verbal speed and word recall and though by no means a cure was greatly helping to control the "brain fog" associate with the "loss of executory function," disorganization, etc.

While the machine was sent back the next morning and a new one is being ordered as a back-up in any event, I don't expect to have a machine in hand until - realistically - the middle of next week: where I only got around to pleading with my doctor to buy a spare for ASAP delivery on Thursday night.

Just to chart what's happened in the interim, by the second or third day off the unit, I was completely unable to keep my focus, flitting from task to task with little or nothing getting done. By Thursday - 4 days into it - I could feel a real problem with delayed word recall. And finally, late Friday night, I became aware of significant edema in both ankles, on account of which I've had to hit the Lasix/Rx potassium supplement combo for the first time in maybe as long as six months!

Bottom line: Ballerina had a profound insight when she realized that tDCS could be valuable when utilized as a maintenance therapy for CRPS. It's just that it doesn't work so well when it's not working. (Go figure.) So, from this point out I'm going to be keeping a spare around. (And at $280, it seems worth the money.)

In any event, I just wanted to chart the time(s) of symptom re-occurrence for whatever value it might have for anyone else.

Be well all,
Mike

Thanks for all the info, Mike.

No problem. And FYI, the fun was only beginning where the pain became incredibly intense Saturday evening - certainly the worst since my last "device failure - on account of which I suspect there's some rebound mechanism in play.

But then it occurred to me, when I started tDCS in earnest, last July or so, I began to have nasty headaches that went on for weeks, until I did some checking an found out the Dextromethorphan HBr (DM) I had used with good results for some time along with a potentiator - brand name Nuedexta - was seriously interfering with the brain plasticity required for successful tDCS, something that can be helped along with small doses of the prescription antibiotic Seromycin (cycloserine).

In any event, where the pain was just OUT OF CONTROL early Saturday evening, with all the Schedule II resources available to me, I realized that I just had to grab the Nuedexta/DM combo and I should be fine. And half an hour later, I was! (And so could briefly go out to dinner with my family.) Now, 9 hours later, having stayed up way, way too late to get out a difficult email to one of my kids' doctors, I'm somewhat cross-eyed from the DM. But it's a small price to pay, really. And once the replacement tDCS devive come in next week, I'll just take a couple of Seromycin over a 24-hour period before I fire up the machine. at which point I should be right as rain. (Here's hoping in any event.) :winky:

Mike

Glad you've got that pain under control!! Maybe a little champagne tonight may really do a number on the pain!! ;) Have a Happy New year. :)

So much info
 

You are a wealth of info just like Ballerina. I haven't been on this thread for some time now since having failed getting any improvement from the tDCS regement. So I have a machine collecting dust if you'd like it. If you don't mind my asking, where is your main pain and who follows you? Where are you getting the Seromycin from? What is your nuedextra? I never heard of that as a treatment. Did you hook up with Doc Fugedy to begin with? That's where I started, I'm not sure if you were on this thread at the time I was going thru the test runs of his treatment schedule. I wonder if your doc gave him the idea for the seromycin. Anyway, my friend and I were a complete failure of the treatment neither of us had any improvement from the treatment and we are now just lost causes to Doc Fugedy. He's never called to see how we are and he's never followed up. Some way to operate. I for one am very disillusioned in the tDCS catagory. So glad to see there are some people making headway in the tDCS catagory. So glad you can get some relief one way or another. I know for awhile another person on here was writing about her success (Catra), but I don't see that she's written much lately. I hope she's doing well. Good luck to you Mike and please keep us all up to date. Happy New Year.

I have been doing very well for the most part Hampster...thanks! I've just been very busy with this being the holiday season at work (retail). We've been working 6 day work weeks and I've just been terribly exhausted and only posting here and there where I felt like I really had something to add to the discussion. Just had a really bad flare on Christmas when I got careless and opened a gift without my gloves, grabbed it full on in my right hand, and it was ICE COLD metal from being in the car. My whole hand swelled up, arm went into a flare, fingers clawed...it was the worst I have been in a LONG time. Flare lasted about 2 days but then I was basically back to normal. I've been trying to be careful and at the same time pushing myself way too hard at work. So I get minor flares here and there but they don't last very long usually as long as I treat them with Lidoderm patch, hot bath, and ultrasound (not all at the same time obviously...lol).

I'm still doing one tdcs treatment a day...though I admit to missing one here and there depending on my work schedule. Now that Christmas is over I should be able to get back on a more regular routine.

just sent the following email to my wife and docs, no reason not to go public
 

Was driving to an appt. w/ Dr. Richeimer and realized I was impaired before I got to the bottom of [my street], turned around and came home. Whereupon I called USC to reschedule my appointment and am calling [my shrink]'s office now in order to discuss my medications and find out what God's friggin name is going on with the delivery of the tDCS device. Assume it's just a transient (I) being off the tDSC (2) lack of sleep and (3) the interaction of dextromethorphone HBr (DM) with all my other meds.

FYI

Mike

important correction to my last
 

None of what I wrote should be read to gainsay tDCS. But we have to recognize it - like so many treatments for so many ailments is is commitment for the long run or until some thing better comes along - and therefore treat it with the respect it deserves, e.g., having back-up units immediately available!

And as to the failure, of the Activa II, I had blown another one using more current than I had of late, but where I personally blew it was not taking Dr. Fugedy's personal advice to stop using it, wait for the remission of symptoms, and then resume use until achieving remission again and so forth, until I figured out a pattern of days of days-on-and-off going with it henceforth.

That said, the suggested pattern might only prolong the inevitable failure of the unit, if used at even slightly higher than the recommended levels, even though the device is calibrated to produce higher output.

As such, on the next go-round, once I achieve remission (please) I'm planning to titrate down by first reducing the current and/or delivery time, to see if this old guy can resume "stasis," and taking things from there.

Mike

I really would like to try this. I just cannot wrap my head around all the pages and pages of info here though.

I go back to my neuro next week, and would love to take the RSDA newsletter to him, and see what he thinks about this. I cannot afford the meds I used to take, and am finding myself in a dark hole...

Can my neuro contact any doctor to get more info? What would I need to give him to get this started?

mike - I hope you figure out what is going on! Big hugs, friend!