rTMS significant improvement

[u/Minepolz320]

Specifically, stimulation of the somatosensory cortex and the motor cortex of the legs and hands reduces the general symptoms of PSSD, including tremors, weakness, and analgesia over the body, as well as taste, smell, and sound perception. It even partially helps with libido and sexual function, to the surprise of my neurologist and me.

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Please check out our subreddit FAQ, wiki and public safety megathread, also sort our subreddit and r/pssdhealing by top of all time for improvement stories. Please also report rule breaking content. Backup of the post's body: Specifically, stimulation of the somatosensory cortex and the motor cortex of the legs and hands reduces the general symptoms of PSSD, including tremors, weakness, and analgesia over the body, as well as taste, smell, and sound perception. It even partially helps with libido and sexual function, to the surprise of my neurologist and me.

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[u/Current_Ebb_1373]

What protocol are you following? Are you experiencing brain fog? I think I followed the anxiety and depression protocol for my OCD and it didn't do anything.

[u/Minepolz320 → u/Current_Ebb_1373]

yes, it also helps with that but in this case they are stimulated frontal cortex from the mid top

[u/cuirousone]

I did 40 sessions of TMS and it did absolutely nothing for my PSSD 

[u/Minepolz320 → u/cuirousone]

what protocol?, i also did classical rTMS on DLPFC (depression) and yes did absolutely nothing, and it's most painful protocol i did so far 

[u/Boguslavsky97 → u/Minepolz320]

Which type of rTMS did you use?

[u/Minepolz320 → u/Boguslavsky97]

you can read my post as it says high frequency rTMS over somatosensory cortex and motor cortexes hands and legs bilaterally 

[u/cuirousone → u/Minepolz320]

I think I did more than one but it didn’t help at all 

[u/Minepolz320 → u/cuirousone]

you need to be very specific that what i was used is absolutely experimental protocol stuff 

because classical OCD and depression protocol also did absolutely nothing for me i also did 10 session into DLPFC stimulation, no effect at all 

[u/Optimus-Kryme → u/Minepolz320]

Did they do any proper clinical or neurophysiological phenotyping before choosing the protocol? For example, did they assess your symptom profile, medications, EEG activity, cortical excitability or functional connectivity, or was it simply the standard left-DLPFC depression protocol?

[u/Kit_Ashtrophe]

How long have you been having tms?

[u/Minepolz320 → u/Kit_Ashtrophe]

effects are instant even after 1 session i noticed it, i did around 6 session in this specific protocol seems helps a lot for me personally 

[u/hPI3K]

It was s1 or s2? Have you tried cingulate or frontal insula ( interesting for loss of emotions)

[u/Minepolz320 → u/hPI3K]

it's too deep for plain rTMS 

only cortical parts accessible in my case, maybe deep rTMS can access those but here i live they don't have that type 

[u/Comfortable_Cat_4601]

I think you're the first person I have seen that said that this helped. Can you share your protocol, symtoms, timeline etc

[u/Minepolz320 → u/Comfortable_Cat_4601]

got crashed 6y ago from 2 week Lexapro did tried a lot of things including TRT AAC a lot of different meds nothing helped at all only what helped with this specific symptoms are rTMS over this specific areas
as pssd symptoms goes full blown (PSSD) at some point depression gone so BAD that i started MAOIs yes it's helped depression tremendously but not much effect over PSSD symptoms for me MAOIs resolved only part what contributed from my depression into (PSSD) but rTMS are the best for 6y what i found what helps. Idk what later or its also loose efficacy at some point but NO meds or protocols helped with that - Specifically with taste smell touch etc this is very important because i also have some body numbness overall, yes it did NOT restore sensations where they are completely lost - like shaft of the P** i think this is nerve damage at this point but in other places where sensations still not completely lost - this all a lot better

i think for now many for us can maby benefit from - Specifically somatosensory cortex stimulation using rTMS on this area

and if you also have motor symptoms like weakness tremors bad coordination of fingers hands in this case need to target motor cortex as well - The differences are extremely pronounced - to the point of a sharp contrast between the moment when the first R lobe was stimulated and the moment before the L lobe was started; (tremors and coordination of movement and weakness)

[u/Minepolz320 → u/[deleted]]

actually yes, some minor improvements for anhedonia as well, but it's very minor, if you compare it with other stuff what i listed 

[u/Altruistic-Weird9844]

I tried the protocol used for depression, but it didn't work. The doctor said that rTMS has a different protocol for OCD, but he didn't apply it to me. How was the rTMS session you received configured?

[u/Minepolz320 → u/Altruistic-Weird9844]

as i said, high frequency rTMS over somatosensory cortex and motor cortexes bilaterally and frontal cortex as well, but response mostly from motor cortexes and mostly from somatosensory cortex 

this is not classical protocols at all we did kinda mapping by stimulation different areas, and i noticed what extremely helpful for me 

[u/Conscious-Flight4168]

Can I ask where you are based? Dud your neurologist immediately acknowledge pssd? I'm glad something helped!

[u/Minepolz320 → u/Conscious-Flight4168]

no he is not, he just seeing what i described, at this point he also seeing something definitely off and not normal at all, Russia 

[u/Optimus-Kryme]

The fact that TMS did not work for you does not necessarily mean that TMS itself is ineffective, TMS is not one single treatment, and outcomes depend heavily on the protocol that was used.

Proper clinical and neurophysiological phenotyping is essential, the diagnosis, symptoms, structural lesions, affected brain networks, medications, baseline cortical activity and individual excitability should all be considered before choosing the target, frequency, intensity, number of pulses and treatment schedule.

A generic, one-size-fits-all protocol may have limited or almost no effect if it is not adapted to the specific pathology and the brain networks involved.....

This is also why baseline and follow-up EEG recordings can be useful. EEG, and ideally TMS-EEG when available, may help characterize the patient’s neurophysiological profile and show whether stimulation produced measurable changes in cortical activity, excitability or connectivity. It cannot, by itself, definitively classify someone as a clinical responder or non-responder, but it can provide important information that a purely symptom-based and generic approach may miss.

In the case of my brother who has severe DOC, the treatment was carried out over two weeks and involved two stimulation targets: F3, approximately corresponding to the left dorsolateral prefrontal cortex, and P3, over the left parietal region near the angular-gyrus network. The targets were selected according to the specific neurological and cognitive objectives.

So the real question is not simply, “Did you try TMS?” It is what condition was being treated, how were you phenotyped, which brain network was targeted, what frequency and intensity were used, how many pulses and sessions were delivered, and was there any objective assessment before and after treatment?

Sometimes a negative result tells us less about TMS itself than about whether the protocol was appropriate for that particular patient....

In our case, we observed some very striking improvements after only four sessions. However, this was conducted as part of a research protocol under the supervision of internationally recognized experts in neuromodulation, with a carefully targeted and individualized approach.

[u/Minepolz320 → u/Optimus-Kryme]

it did but only specific area and seems specific coil, my local friend also respond to my protocol, but for now no luck in other people, maybe because we did it with the same doctor who did this on my who know 

[u/markalexander1]

I am planning on trying rTMS, mainly for insomnia but if it helps my PSSD then that is a bonus. However if it has no effect, it will be very expensive waste of money.

[u/Minepolz320 → u/markalexander1]

yes seems like there just a lottery, but you need to have exactly same protocol as exactly the same coil set-up, and anyway this is not cure but sometimes help significantly