TMS was performed using a MagProX100 stimulator and the MR- compatible MRi-B91 (MagVenture, Farum, Denmark) TMS coil. During session 2, the stimulation intensity was defined for each participant based on resting motor threshold (rMT). rMT was determined as the lowest stimulator output resulting in 5 out of 10 visible twitches of the right first dorsal interosseous muscle [76]. Motor threshold definition was performed inside the scanner room, using the sandwiched TMS and 7-channel receive coil array.
Using a Polaris neuronavigation camera (NDI, Waterloo, Canada) and 3D- printed metal-free optical trackers for participant (mounted onto a mouthpiece) and TMS coil, the coil was positioned on the individual DLPFC target and fixed using a suitable holder (MagVenture, Farum, Denmark).
I was advised to use neuronavigation-based mapping. There are LOTS of TMS clinics, and this is a major expense, so doing it right is important.
There’s also MeRT (brainwave-guided) btu they don’t use fMRI to localize.
Still, random TMS may not be targeted to my needs (too much slowwaves), whereas MeRT theoretically might be [but it’s new and there are negative reviews]. Some people are so desperate they’ll try it, and maybe I’ll have a sense of whether or not it’ll work after the first $4200/week (which isn’t the worst cost, and its cost scaling is not overwhelming like the fMRI-guided TMS in NYC)
tACS is not seen as effective as TMS, but there’s a tACS practitioner who is willing to go deep with me with my data, and the simple prospect of working with him alone seems worth it, b/c all of the TMS practitioners just seem to want your money and don’t care about you otherwise…
I make hardware and software for doing EEG neurofeedback. I’ve been working in this field for about 30 years. For many years I worked in a neurology clinic doing EEG bioeedback and quantitative EEG assessment and then I had my own practice
for several years. The effect size of brainwave biofeedback for ADHD is about equal to that of stimulant medication. However unlike the medication, the neurofeedback can make physical changes in the brain and electrical changes in the EEG patterns. With children who have a more plastic brain than adults, this kind of training is likely to produce permanent changes. Adults may need occasional booster sessions to keep the symptoms away.
If somebody is
charging you $4,500 a week to teach you how to change your brain function and you’re paying it, consider buying the Brooklyn Bridge. That’s way too much.
People typically need between 20 and 40 EEG Biofeedback sessions to fix ADHD. When I was practicing 15 years ago, $100 a session was a pretty typical cost.
The neurofeedback has wo parts. One is learning how to control your brainwaves. The other part is the effect of changing your brainwise several times a week in sessions for a long enough period time to rewire the circuitry associated with attention.
Think of it as other kinds of exercise. The first thing you do is learn how to use the weight machines and then you use them for many hours and you see changes in your performance and also changes in your physical tissue.
Mario Beauregard worked at a Canadian University and got an excellent grant that allowed him to have 30 people in his treatment group and 30 people in the control group and to do pre-post FMRIs.
Treatment and control group both got stimulant medication and the treatment group also got brainwave
biofeedback two to four times a week until they had 30 sessions. The control group had some kind of counseling intervention and maybe video games.
Both groups had greatly reduced ADHD symptoms because they are both on stimulant medication. At the end of the experiment, everybody stopped the medication. The kids who had the EEG biodeedback did not have symptoms return at the same rate and the kids who had medication only had the same symptoms as they started with the next day.
This kind of effect has been replicated many times.
Tiff Thompson and her husband Nick Dogris are both PhD level psychologists and they’ve done neurofeedback and near modulation with stimulation for a very long time and and they’re both good at it.
