Originally Posted by iguanabill (Post 845200)

Okay, Ballerina, here are the full details:

We are delivering the standard 2.0 mAMP for 20 minutes, resulting in a total dose of 40 mAMP minutes. She tolerates this okay.

We are using anodal stimulation (I incorrectly wrote cathodal stimulation in prior post), with the red (positive) lead over the right motor cortex (contralateral to the area of her worst pain, on the left side of her coccyx/perineal region), and black (negative) lead at the left supra-orbital position. Everything I've read suggests anodal stimulation of the motor cortex to be most efficacious for chronic pain.

We are using the following system components to deliver the current:

1) Iomed Phoresor II Auto iontophoresis device

2) 3" x 3" Amrex rubber pad w/ sponge insert (actually 2" x 2" contact surface with skin; 25.8 cm2)

3) pin to banana pin adaptors (to insert into the rubber pad)

4) (3) snap to pin converters (to connect between the electrophoresor's wires and the pin to banana pin adaptor)

I bought these >2 years ago, and tried to list the websites I purchased them from (still valid)**edit**

Again, my question is simple: are you finding a lead position that works better than that which we are using? If so, what is it, if I may ask? I hope you have continued to experience improvement.

Originally Posted by sberube (Post 845260)

Ballerina;
Would you consider posting a youtube video on how you use the unit and where you apply the pads? This is such an inexpensive option to try I think the more info we can learn and share it could help a lot of people out. Thanks so much

Originally Posted by voner (Post 845283)

iguanabill:

thanks for your post. Your questions are helping sort through the details of tdcs.

I would guess that you need to give ballerina a more specific description of of the location on the head you are placing your anodes/cathode...

from reading the research papers, I think the accepted paradigm to use is the EEG 10-20 system... most the researchers have put the For example, many researchers put the anode over the “C3” area (which correlates to the hand position for the Penfield brain map (I cannot post Web addresses yet -- I don't have enough postings)..

I'm curious about the same things you are. I am about ready to start some trials.

Thanks a lot for posting your information about the electrodes etc!! The part about the adapters to the banana plugs, etc. threw me for a loop for a while.. .. I kept on trying to figure out if I needed to order what other parts etc. etc.

So, anybody else reading this and also using the Square Amrex type rubber edged sponge electrodes---pay attention to the adapter part that iguanabill has stated. I ended up going down to a local electronic supply store and buying some banana plugs cutting the leads off the wires, and soldering banana plugs through the wire ends. I then tested the device on my multimeter to ensure the device was working correctly in putting out a steady 2ma.........but if I could have found some adapters -- I probably would've used the adapters that iguanabill used...

Originally Posted by lovefamilypets (Post 845396)

Hi Ballerina and others who have posted about this topic!

Unfortunately, I have no scientific background so reading about T.D.C.S has been a bit confusing for me.

However, I did find a doctor in Sacramento who is doing Transcranial Magnetic Stimulation for patients with depression. He seemed willing to look into TMS for chronic pain; it seemed like he inferred there might need to be a change in where the machine was placed on the head.

Anyways to my point, is T.M.S. similar to T.D.C.S.? Is it worth giving T.M.S. a try? Or is T.D.C.S. the only way to go?

I would greatly appreciate any info or advice in this matter. Thank you all for your posts about this topic. I hope this is something that helps more of us.

Originally Posted by sberube (Post 845260)

Ballerina;
Would you consider posting a youtube video on how you use the unit and where you apply the pads? This is such an inexpensive option to try I think the more info we can learn and share it could help a lot of people out. Thanks so much

Originally Posted by lovefamilypets (Post 845396)

Anyways to my point, is T.M.S. similar to T.D.C.S.? Is it worth giving T.M.S. a try? Or is T.D.C.S. the only way to go?

Originally Posted by ballerina (Post 845441)

I have had a better response to anodal stimulation of the motor cortex and secondary somatosensory cortices (M1 and S2.). To place the electrodes for this protocol place the anode (red) over the auditory canal, just above the ear (contralateral to painful limb.) Be sure the top of the ear does not become caught under the electrode. Ditto for hair. Place the cathode (black) over the opposite eye.

Originally Posted by iguanabill (Post 845481)

I have to agree with ballerina's remarks above; when one reads the literature, tDCS seems to have a stronger evidenciary basis for efficacy than rTMS. We blew over $25,000 on two separate facilities giving my wife rTMS. She didn't respond well. Part of the problem for her, however, was that she had to sit on her bum during the treatment (there is no getting around this), which is her most painful area. The treatment seemed unable to overcome the insult of additional pain provoked by sitting.

The first treatment targeted her left prefontal cortex area, where they ordinarily treat depression. The second, with Dr. Sheldon Jordan in Santa Monica, CA, whom we greatly admire and dearly appreciate, targeted both the depression area and her right (contralateral to her worst pain) secondary somatosensory cortex. He reasoned that most alternative brain regions lack "memory;" that is, deep brain stimulation, for example, only works when stimulation is continuous, but fails as soon as the signal is turned off. He believed that the secondary somatosensory cortex had sufficient memory to "remember" the change in activity well beyond the end of the treatment. I thought the idea was brilliant. My wife's brain was indifferent, however. After both series of treatments, we had to return to the one treatment that seemed to help her condition the most: electroconvulsive therapy (ECT). She really hated ECT, but it's very effective brain stimulation and, because our insurance covered it, we were able to use her retirement funds for other (largely futile) options.



I like this idea, ballerina, as it reminds me of Dr. Jordan's approach. The secondary somatosensory cortex is deeper, but I imagine your electrode position just above the ear allows the current to penetrate it. Very interesting. Will definitely try this. However, unless one shaves, it's inevitable that hair will be under the electrode, so I'm confused by your comment. And for other readers, what ballerina surely meant was that the cathode (black) electrode is placed above (not over) the opposite eye. One thing to be careful about, I've read, is to keep the electrode well above the eye.