That’s what I remember thinking the first time I figured out that they were talking about opening your skull and planting electrodes into your brain. Then I thought… Imagine being so desperate that that would seem like a sensible next step in your course of treatment. And then I thought… Wouldn’t it be amazing if tDCS, Focused Ultrasound, or now Temporal Interference, could replicate the results without the surgery.
Recently the always excellent Invisibilia podcast covered DBS as applied to depression and OCD. We hear from the patient, her boyfriend and the doctors involved. I have a completely new understanding of the procedure and its effects. I highly recommend a listen to this episode.
This github project is a step-by-step manual. Anyone with a high school diploma should be able to follow it and build a TMSuino themselves. That’s what I was aiming for. TMSuino’s principle of operation is taken from a scientific paper published in the 1990s. So it is free of valid patent claims. Costs for parts, materials and shipping should be around 150,- dollars/euros. There is no soldering required! Estimated build time is 2 1/2 hours.
A comment on the blog from Martin Mueller informed me of this very interesting new arduino-based TMS device. I’ve also posted a link to the r/diytdcs Reddit page in hopes of hearing feedback from more technically-minded folks. I will update this post as info emerges. TMSuino3 seems to be loosely based on the work of Steen Dissing whose device we looked at in 2015 (see below) where it’s referred to as Transcranial Pulsating Electro Magnetic Fields therapy or t-PEMF.
The Introduction to the github article collects the author’s frustrations and suspicions around transparency in the bipolar research community and basically comes away from the experience hypothesizing what sounds like a conspiracy. Wait, big pharma and medical device companies manipulating the market to ensure maximum profit? Either way, he shares an article that confirms Steen Dissing’s frustration in getting his device accepted and adopted for treatment of depression in Denmark. An Inventor’s Triumph and Frustration.
It turns out a medical grade device has been developed and approved for treatment of depression in Denmark. The Re5, made by Navamedic. There are a collection of research papers linked to at their site.
————————– Original 2015 article.
Thanks to reader Jerico for alerting me to this. Transcranial Pulsating Electro Magnetic Fields therapy is new to me. It does not seem to be experiencing anywhere near the level of research activity that is going on around tDCS. Some of the research I’m finding dates from 2001 (though the BBC article the quote is from and linked to below is from 2014). But just to have it on our radar, and because the helmet looks so cool…
“The helmet is amazing,” said Annemette Ovlisen, a graphic artist who suffered recurrent depression for 16 years and a participant in the Hillerod trials.
It’s like the fog lifts. It was like somebody hit the reset button.”The device contains seven coils that deliver a dose of Transcranial Pulsating Electro Magnetic Fields (T-PEMF) to brain tissues.The pulses are so minute that the patient cannot detect any sensation, and the only side effect so far is occasional “tiny” nausea that immediately disappears after treatment.
Prof Steen Dissing, of Copenhagen’s Faculty of Health Sciences is the helmet’s principal architect.
He said: “The device mimics electrical fields in the brain, and triggers the body’s own healing mechanism.”
The pulses activate capillaries in the brain, which form new blood vessels and secrete growth hormones.
I’ts like somebody hit the reset button and I was back to normal.
Insurers are starting to cover TMS for depression (after determining that SSRIs or other medications aren’t working for the patient). A full course, 24-36 treatments, of TMS can cost well over $10k. Though this is purely conjecture on my part, one way tDCS might make it into the mainstream is as a method to ‘top up’ post-TMS treatment as effects begin to fade.
Published on Jun 19, 2017 | YouTubeUCLA
As the number of people suffering from depression rises, doctors are looking for new, more targeted ways to treat it. One approach used by doctors at UCLA and a handful of other centers nationwide is to beam magnetic pulses deep into patients’ brains, a therapy known as transcranial magnetic stimulation (TMS). The therapy is time-consuming, and only a few hospitals or clinics offer it, but its ability to work in a fundamentally different way from medications is also what makes it so promising for people not helped by drugs.
Finnish company Sooma manufactures and supports a tDCS device for the treatment of depression (in Europe). They recently added clearance to treat pain in Canada, and I would assume, are aggressively working towards clearing their device for the treatment of depression in Canada and the U.S.
I would recommend muting the sound (captioned so not necessary) in these next two.
In South Korea, Ybrain is betting that these benefits and its slick consumer-friendly design will speed adoption of its device. “It’s designed for home use,” says Ybrain CEO Lee, “so physician can electronically prescribe the device and patients can bring it to their homes.”
Analysing these high-standard studies revealed that tDCS seems to reliably improve the symptoms of depression, addiction and craving, and fibromyalgia. It also uncovered that the technique does not work for tinnitus, and that the evidence for using tDCS for stroke rehabilitation was not as strong as many had thought.
Stumbled upon this device today, the Omni Stimulator, which seems to be mostly sold in Australia. That lead to this video where Brendan Morgan makes the case for the use of tDCS in the treatment of his depression. Again, I am not advocating the use of tDCS for the self-treatment of your depression. I’m simply collecting evidence, clinical and anecdotal, and making it available. That said, I know that if I myself were experiencing depression, I would be experimenting with tDCS. Especially in light of the fact that the efficacy of treatment of depression with SRRIs remains controversial, tDCS would definitely seem to be worth a try. [Highly recommended, Science VS podcast episode #11 Antidepressants.]
We developed a cellular brain stimulation device as part of our ELEC5622 Sensors, Signals & Health assessment at the University of Sydney. The technique, known as transcranial direct current stimulation (tDCS), uses weak electrical currents to modulate ongoing brain activity, and is a promising treatment for a range of neurological and psychiatric diseases. As the feasibility of administering tDCS at home has recently become an emerging area of research, there is a substantial need for a tDCS device which send data to the clinician in real time.
[Update 11/7/16 The video mentioned has been deleted.]
Now that TMS has been approved for the treatment of depression we’re seeing a lot more stories in the news. Naturally this is in part due to the marketing efforts of the four device makers currently FDA approved: Brainsway, Magstim, Magvita, and Neurostar. No doubt patients and doctors are eager to try an alternative where antidepressants didn’t work!
I will update this post as I find new and interesting news stories related to TMS and depression.
Fidel Vila-Rodriguez, an Assistant Professor of Psychiatry at the University of British Columbia, is exploring the effects of transcranial direct current stimulation combined with yoga, to see if it can be used to treat depression.
Market forces, the for-profit bias that imbues every aspect of health care in America, skew R&D towards solutions and products that are highly profitable. That’s one of the reasons I was so curious about tDCS. You can do it at home. It doesn’t cost a fortune. My initial curiosity was inspired by research papers that seemed to indicate the potential for cognitive enhancement, primarily memory and learning. Many papers later, I’m not so sure, but where it comes to tDCS and depression I’m much more confident. There does seem to be an overwhelming amount of both research and anecdotal evidence to support the use of tDCS in depression. If that were better known, perhaps someone like the woman featured in this NBC news clip would have had somewhere to turn when she was denied coverage for continuing TMS treatment for depression.
No mention of tDCS in his journey to find relief from severe depression, but some new to me and interesting information about treating his depression with Transcranial Magnetic Stimulation. Especially interesting is that a genome test recommended by his psychiatrist led to the awareness that many of the drugs typically used to treat depression would most likely be overwhelming to his system. Also that his insurer, Anthem Blue Cross (through the ACA, Obamacare) covered his TMS treatment. Links below to full article.
Transcranial Magnetic Stimulation, or TMS, is a depression treatment that was approved by the FDA in 2008. It involves placing a magnetic coil on the patient’s head, and stimulating neurons in a specific part of the brain known to be underactive in depression (the dorsolateral prefrontal cortex). Best of all, it has very few side effects: only some uncomfortable tapping on the head where treatment is applied. There are none of the standard side effects we’ve come to associate with medications.