Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)

 
 
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Old 01-27-2012, 03:47 AM #11
ballerina ballerina is offline
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ballerina ballerina is offline
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Quote:
Originally Posted by iguanabill View Post
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.

Wow Iguanabill,

I am so very sorry for the numerous treatment failures your wife and you have endured. I so hope that you both find success with tDCS. At least you can try different protocols in the comfort of your home without breaking the bank.

I apologize for the confusion regarding hair impeding the electrode. When using this particular electrode placement close, direct contact with the scalp can easily be impeded if the top of the ear becomes lodged under the edge of the electrode when being wrapped with ace bandages. For some reason, my hair easily becomes lodged under the electrode or above my ear just under the edge of the electrode. Since I do my treatments without assistance, and have limited range of motion in my right arm, this might be more of a problem for me than for others.

Thanks for the clarification regarding cathode placement-so corrected in my prior post-above the eye.

I am keeping your wife in my prayers that tDCS gives her the kind of relief I have found!!!!!!!!!!
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