OFF LABEL USE _ THIS IS NOT AN ADVERTISEMENT FOR PHYSICIANS ONLY

Indications

Protocols

EEGTMS

Indications

  1. Addiction/EtOH

  2. ADHD

  3. Auditory Hallucinations

  4. ChemoBrain

  5. Chronic Fatigue (CFS)

  6. Dementia

  7. Depression

  8. OCD

  9. Panic & GAD  

  10. PTSD

  11. Schizophrenia

  12. Suicidal Ideation

  13. Traumatic Brain Injury (TBI)

NEUROLOGICAL

  1. Parkinson's

  2. Conversion/MUPS/FND

  3. Dystonia

  4. Epilepsy

  5. Pain 

  6. Stroke

  7. Tinnitus

  8. Tourette’s

  9. Tremor

 Other Protocols

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PLEASE DON’T REFER TO THIS AS “Rustin’s List” I have no intention of taking credit for the investigators who have carryed out the published studies these are taken from. (but thank you for thinking of me)

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TMS for PTSD

Indication Anxiety: PTSD, GAD)

Location R-DLPFC(F4)

Notes cTBS 2min on, 1min off, 2min on

Frequency 1 Hz or cTBS

Train 60

Pause 1

Duration 20

total time

# sessions

Notes

1) Cohen 2004 Repetitive transcranial magnetic stimulation of the right dorsolateral prefrontal cortex in PTSD: a double-blind, placebo-controlled study

10Hz, 80%MT, 5/week x 2weeksRight DLPFC, n=24

2) Watts 2012 A sham controlled study of repetitive transcranial magnetic stimulation for posttraumatic stress disorder.

3) Boggio 2010 Noninvasive Brain Stimulation With High-Frequency and LowIntensity Repetitive Transcranial Magnetic Stimulation Treatment for Posttraumatic Stress Disorder

20Hz, Right vs Left DLPFC 2 sec on, 28 secs off x 40 trains (20 min, 1,600 pulses, 5 days /week x 2 weeks, n = 30


 

EEGProcessing: Clean . Plot. Read. Treat

We are here to help people & reduce suffering. Let’s Learn How To maximize TMS effectiveness using EEG

To get started

1) Buy system (we are agnostic about which one, we have used Cognionics, Emotiv (Epoch and Insight), NeuroField (not dry, not wireless) & we will be adding Advanced Brain Monitoring and Wearable Sensing. Info on those may be available in the next few weeks.

2) Get some training from that manufacturer about about recording EEG

3) Do 3 EEGs patients, family or friends

4) Email EDF files (the standard) to eegtms.absc@gmail.com or eeg4tms@gmail.com (or get link and copy to dropBox)

we will process your EEGs if needed, If and only if the files are labeled:

Naming Standard

FirstName_LastInitial_EEGnumber_date_Condition

Eyes open or eyes closed

For example 

Nathan_A_07_01_12_2019_eO

Nathan_A_07_01_12_2019_eC

So for each number there will be an eO and eC

If you record both on one file use “ _both”

Like 

Nathan_A_07_01_12_2019_both

If you want processing AND interpretation:

Age, handedness, gender, and Chief complaint

Eg: 45 year old right handed male presenting for CC anhedonia

If you are ready to start Processing for yourself:

1) Download MatLab, and Signal Processing toolbox

2) Download EEGLab

3) Download these plugins and put them into Plugins Folder in the EEGLab folder

Biosig

MARA

Microstates

obviously these instructions are simplified and meant to provide a starting structure when treating uncomplicated Major Depressive Disorder (when was the last time you saw that?)

 Read the EEG Brain Scan - Interpretation

Look at picture

1) Is the IAF peak (between 8 & 12) at 8Hz? ••• . Predicts non-response with regular 10Hz TMS

2) Is the IAF peak at 11hz, 12hz or 13hz? •••   Do 11hz, 12hz or 13hz instead of 10hz (or do theta burst)

3) Is the right frontal lobe hyperactive (red) and left hypoactive (more blue)? Yes? Ok, continue as usual… •••   

No?

Option I) inquire about handedness (use Edinburgh handedness scale if needed)

Option II) start as usual but switch quickly if no response or gets worse

Option III) excite left, or inhibit right

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Microstate Interpretation

see video

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For consultation and experienced EEG-TMS assistance 619-804-8004

For consultation and experienced EEG-TMS assistance 619-804-8004

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Look before you stim! If you wish to add EEG to your TMS practice, we can help. We have tried to make everything as easy to use, and software free for download, but…. if you are experiencing technical challenges we are always here. Please text 619-804-8004 . …..Rustin

How valuable is an expert opinion?

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