Transcranial Stimulation Treatments (rTMS & tDCS & tACS)

Thanks for your reply!

 

Have we made any progress on this?

Back in 2009 I saw an ENT who was convinced that rtms was just on the verge of being approved for tinnitus as soon as they got done getting the protocell right and he anticipated being able to offer it to me in his office.

 

I called UCLA TMS. The treatment consists of 36 sessions which you need to do every day, M-F, for 6 weeks. They start to taper at the end. Each session will last 30-60 minutes. If you have insurance, it should be covered. I didn't ask for the out of pocket cost as I knew it would be high and I wouldn't be able to pay for it without my insurance. This old link has an average cost of $9k.

https://abc7.com/archive/6999817/

 

I'm frankly very surprised insurance would cover this. Maybe for depression, but for tinnitus?

 

I'm sure they are skilled at getting the treatment covered by insurance, otherwise few could afford it. I think being on anti-depressants first is a requirement. I would imagine there isn't much difference between TMS for depression and tinnitus.

 

Actually the treatment has to be configured for tinnitus specifically. If you do TMS for depression it may worsen your tinnitus because it is configured to be excitatory. The protocol is different.

They do it at Brai3n in Ghent but they do a qEEG first. There is a private psychiatric centre that does TMS in London for depression. It's super expensive. I called them and they claim they can reconfigure the treatment for tinnitus but they weren't able to tell me how many patients they treated for tinnitus and the success rate.

My neurologist told me TMS treatments are not very effective for tinnitus. Given the cost and the lack of data from this London practice ran by psychiatrists, and the possibility of a worsening, I let that go.

EDIT: this is the link to the treatment in London. They do mention tinnitus explicitly now. Has anyone tried this in London?

https://www.psychiatrycentre.co.uk/...ion-rtms-clinic/tinnitus-treatment-with-rtms/

 

Trying to fix something and making it worse is the story of my life. Lol!

Talk about timing. I saw an interesting post on Reddit from someone who bought a home rTMS device and had a huge improvement in their tinnitus. It may have been an anecdotal result, but it was done in a scientific manner. Here is the device.

https://omnipemf.com/

I think I'm going to make a purchase given the discount.

 

Interesting device. Is it TMS? They talk about electromagnetic stimulation but it's not entirely clear. Which of the following modes did they use?

Theta Meditation
Dominant frequency: 4 Hz.
Magnetic flux density: 2.5 mT.
Accompanying frequency: 10 Hz.
Magnetic flux density: 0.25 mT.

Improve Sleep
Dominant frequency: 4 Hz.
Magnetic flux density: 2.5 mT.
Accompanying frequency: 2.67 Hz.
Magnetic flux density: 0.25 mT.

Pain control
Dominant frequency: 303 Hz.
Magnetic flux density: 2.0 mT.
Accompanying frequency: 12 Hz.
Magnetic flux density: 0.25 mT.

Improve Focus
Dominant frequency: 33 Hz.
Magnetic flux density: 2.5 mT.
Accompanying frequency: 50 Hz.
Magnetic flux density: 0.25 mT.

Meditation for Calming
Dominant frequency: 9 Hz.
Magnetic flux density: 2.5 mT.
Accompanying frequency: 6 Hz.
Magnetic flux density: 0.25 mT.

Deep Relaxation
Dominant frequency: 10 Hz.
Magnetic flux density: 2.5 mT.
Accompanying frequency: 3 Hz.
Magnetic flux density: 0.25 mT.

Energy & Vitality
Dominant frequency: 40 Hz.
Magnetic flux density: 2.5 mT.
Accompanying frequency: 55 Hz.
Magnetic flux density: 0.5 mT.

 

@vttbx, concerning OmniPEMF, I searched the web and I think I found the posts you are referring to. Interestingly, from what I read based on the anecdotal experience, the setting that seems to help is "deep relaxation" but one also needs to position the head device in a somewhat atypical position that is different from the position used for depression/sleep etc. The user that had success said that the headset has to be positioned in front of the ears and that one has to choose two particular frequencies (that I think coincide with deep relaxation).

This is the link provided by the manufacturer for tinnitus, but as you see it is relatively vague. It claims that Pulsed Electromagnetic Field Therapy (PEMF) can benefit tinnitus patients based on this study:

Engel S, Markewitz R, Langguth B, Schecklmann M. Paired Associative Stimulation of the Temporal Cortex: Effects on the Auditory Steady-State Response. Front Psychiatry. 2017;8:227. DOI:10.3389/fpsyt.2017.00227

That is a study for general PEMF and not for the specific device. The manufacturer does not claim to cure tinnitus but says they can help with tinnitus symptoms (I guess anxiety, insomnia etc). However the user I mentioned above experienced periods of remission of tinnitus itself. But this is a sample of one.

There is also a report of one user getting tinnitus from using the device after three weeks for other conditions, but this might be due to the particular setting used, in that it is known that stimulating-type therapies (like TMS for depression) can trigger tinnitus. We know that already. One could then try the relaxing setting with this device, with an ad hoc positioning of the device, and hopefully this could be similar to a TMS clinic treatment? That is another question I have, is PEMF therapy the same as TMS? They call PEMF also low level magnetic therapy but it's not clear to me if this is the same as proper TMS. Here in London proper TMS for tinnitus would cost about £10,000-£20,000 depending on the number of sessions. It's highly standardized as they don't base it on brain scans or anything, so I suspect its effectiveness is not that clear. I can barely afford that with all that's coming up in my life right now and if the effect is temporary and therapy needs to be repeated this would be totally unsustainable, and if it does nothing or worsens me God knows how I would feel, it's already desperation now. A home device would be a much better option for me, given also the COVID-19 issues.

@vttbx, I think the main challenge would be to make sure that the device setting and positioning matches as well as possible the setting of the successful academic papers using TMS specifically for tinnitus. This is a summary paper for TMS that also develops personalized protocols:

Individualized Repetitive Transcranial Magnetic Stimulation Treatment in Chronic Tinnitus?

However this is not the same paper I linked above. This second paper is a real TMS paper and as I said above I'm not clear how much home PEMF devices are comparable to proper TMS therapy. I'm not sure how I would use a home device in a way that matches this second paper as much as possible. Again the user I mentioned came up with some suggestions but they are really very anecdotal and I'm not sure what to do. May I ask you how you plan to proceed? If you feel like answering these questions it would be helpful, but no worries otherwise:

1. Do you think PEMF is really a form of TMS, and is it comparable to proper TMS?

2. What program would you use? Would you agree the relaxation one is the most appropriate in trying to match the frequencies of the above TMS paper?

3. Where would you position the headset?

4. Is there anything else we can do to understand how to best customize the treatment?

 

@vttbx -- I just tried to do a quick look and see what price was. All I could see was 53% off. But they don't say off of what. Do you know what the price is? -- I really hate it when businesses won't even show the price of their products. It's a big turnoff for me.

 

If you click through it gives you the price. Looks like $299 USD with the sale price factored in. You can divide by .53 to figure out the original price if you want.

 

It's $299 US. If you do a Google search, you can find a coupon for 10% off. I paid $269. It took a few coupon searches to find one that works.

 

I ordered my device yesterday and plan to follow the protocol set by the user on Reddit. I believe the setting was "deep relax," with a variation on the headset placement being over the forehead and above the ears. You have researched this device far more than I have, so I can't offer any additional insight.

Great work, by the way. They do offer a 60-day money-back guarantee.

https://omnipemf.com/returns-and-refunds-policy/

 

There is a negative experience with the OmniPEMF NeoRhythm on Tinnitus Talk:

Severe Tinnitus Seemingly from Using NeoRhythm PEMF Device

 

Indeed, this is what he did. The frequencies of the "Deep Relaxation" mode are not an exact match for the ones used in the successful TMS paper but they are the closest you can find in the different settings. I'm still trying to assess how precise the "mapping" from traditional TMS to therapy with this device is. What complicates matters further is that even traditional TMS is not guaranteed to help. We need some luck. I'm thinking about ordering this. I'm a little concerned with a possible worsening as we have two anecdotal reports of worsening, beside the one from Tinnitus Talk I posted above there is one also from Reddit. What is particularly concerning is that the report from Tinnitus Talk concerns a worsening under the "Deep Relaxation" mode. I had hoped the worsening was happening under a stimulating setting, but even the relaxation one used by the successful user caused severe worsening in another instance. On the other hand I think permanent damage is very unlikely and the money back guarantee is solid.

I just wanted to suggest a prudent approach, given the above anecdotal cases. Please let us know how it goes, I would be very grateful if you could update us here. I have not been helped by devices like hearing aids, Parasym or Lenire, so I hope this one may work. Fingers crossed.

 

Humbled again by the mighty Tinnitus Talk community. Just when you think you have found something new, someone has tried it. Thanks for posting!

 

Here's a new vid about Dr. Laure Jacquemin's research (HD-tDCS). It's in Dutch, but you could easily find the translate button. One thing worth mentioning is that she talked about patients who noticed a reduction in their tinnitus (maybe for considerable amount of peeps, but not all of them). We could certainly use some good news given that we have survived this particularly shitty year.

Laure doet onderzoek naar oorsuizen | LabKlap #7

 

I haven't found any translation in English but, in another interview with English subtitles, she says that 30 % improve.

 

Yes, that's right @ThomasC. I remember that she mentioned in an earlier video that she noticed an 30% improvement. Interestingly, she is currently doing another study with HD-tDCS with a few adjustments to the intervention in hopes of increasing the success rate.

 

Just got back from meeting with Jacquemin.

I copy pasted your question into my Messenger so I could ask her literally what you asked. I told her it was a question from a forum member.

Her answer:

"Yes, absolutely I know Susan Shore, I consider her to be a pioneer in the field. But again (she had told me something similar already when talking about Lenire) we are all just trying something at this point. Even my solution is not working for everyone (she still repeats the 1 in 3 statistic). We are looking at tongue tip stimulation and audio stimulation but... (loose quote) I have the feeling that audio stimulation is mostly a temporary patch."​

She pretty much recognizes that there may as well be a lot of different roads, but more research is needed.
But this is literally the first doctor that I have seen that actually knows about Susan Shore and Lenire.

Next steps:

I am now on the waiting list (3 month long list so far) for brain stimulation.

Tomorrow I will go to Brai3n (which funnily enough Jacquemin also referred to when I asked her if she was the only one with this device) but it will obviously be more expensive at Brai3n, even though my insurance is not covering the stimulation at UZA (Jacquemin) either.

It will be interesting tomorrow to get my first qEEG (at Brai3n) to see what my troubled exhausted brain is up to.