Maintenance tDCS: A Case of Full and Durable Recovery from Myalgic Encephalomyelitis/Chronic Fatigue

[Hip]

Electrocute your brain to treat something that may be caused by a lack of pyruvate dehydrogenase activity.
Understood.

That remark indicates you don't have much grasp or understanding of science.

 

[Alvin2]

That remark indicates you don't have much grasp or understanding of science.

ok

 

[Hip]

Why not do a little reading on the subject? This is not the only electric therapy used to treat the brain: there is transcranial magnetic stimulation (TMS), deep transcranial magnetic stimulation (deep TMS), cranial electrotherapy stimulation (CES), transcranial alternating current stimulation (tACS), transcranial random noise stimulation (tRNS), and the transcranial direct current stimulation (tDCS) used in this study.

And for the body there is transcutaneous electrical nerve stimulation (TENS), microcurrent electrical neuromuscular stimulation (MENS), electrical muscle stimulation (EMS), vagus nerve stimulation (VNS), and others.


I would imagine for most ME/CFS patients, tDCS may only provide some minor benefits, if at all. It is not going to be the magic cure for ME/CFS. But I can't see the point in mocking tDCS, because it may provide some benefits to some patients.

 

[ljimbo423]

Electrocute your brain to treat something that may be caused by a lack of pyruvate dehydrogenase activity.

Hey Alvin2-

It could be both the brain (neuro-inflammation, as the article refers to) and low pyruvate dehydrogenase in the mito. - LPS can cause both. There are numerous studies showing that LPS cause neuro-inflammation. LINK

Here is paper showing that LPS cause a Warburg-like effect, like the cell danger response Robert Naviaux talks about, leading to lower pyruvate dehydrogenase in the mito.

How does LPS promote Warburg metabolism in macrophages and DCs?
Activation of macrophages or DCs with a range of stimuli, including LPS10, the TLR3 ligand poly(I:C)11, and type I interferon (IFN)11, induces a metabolic switch from OXPHOS to glycolysis, in a phenomenon similar to the Warburg effect10

LINK

 

[Jonathan Edwards]

That remark indicates you don't have much grasp or understanding of science.

It seemed to me to indicate a rather deep understanding!!

Electrical currents aint going to change the immune system as far as I know.
I am afraid on a score of 1-10 this scores -2 again for me.

 

[Alvin2]

It seemed to me to indicate a rather deep understanding!!

Electrical currents aint going to change the immune system as far as I know.

Thanks

I am afraid on a score of 1-10 this scores -2 again for me.

Again?

 

[Hip]

Electrical currents aint going to change the immune system as far as I know.

Electrical currents may not have any immune effects; but a treatment of ME/CFS (or any other disease) does not necessarily need to act on the core pathophysiology in order to offer some benefit. TENS machines for example may relieve muscular or joint pain in various diseases, but that does not mean the TENS current gets to the core pathophysiology of the pain.

The benefits the ME/CFS patient in this study gets from tDCS may just be a palliative effect, but if it works for this patient, it may work for others too, so there's no harm in trying tDCS. Sure, it probably won't work for most other patients, as the norm with ME/CFS treatments, but you'll never know either way until you try it.

And tDCS is not a Dr Frankenstein exercise, so I wouldn't characterize it as "electrocuting your brain".

 

[Hip]

It seems that tDCS has also been found beneficial for the cognitive impairments of multiple sclerosis: this article details a study on tDCS in 25 MS patients, who used tDCS while playing a computer game.

Another MS tDCS study found that tDCS improves the fatigue in MS, when applied to the motor cortex of the brain.

According to a New Scientist article:

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.

By the way, one set of people who use tDCS headsets are computer gamers, as tDCS has a reputation for improving gaming performance: Can an electronic headset make you a better video gamer?

The military has also found in their tests that tDCS is effective for improving cognitive function:

in a series of experiments at the air force base, the researchers found that electrical brain stimulation can improve people’s multitasking skills and stave off the drop in performance that comes with information overload. Writing in the journal Frontiers in Human Neuroscience, they say that the technology, known as transcranial direct current stimulation (tDCS), has a “profound effect”

Improving multitasking skills and preventing information overload sounds ideal for ME/CFS, as most ME/CFS patients are aware that these are two areas of weakness in ME/CFS brain fog.

If someone interrupts what I am doing, I can completely loose track of where I was (poor multitasking); and whenever I am in any complex or fast-moving environment, my brain struggles to keep up (poor performance under information overload).

Though under some circumstances and for some people, tDCS can reduce performance: Warning over experimental brain boost

 

[Woolie]

@Hip, some of these tDCS studies are not to be relied on.

It seems that tDCS has also been found beneficial for the cognitive impairments of multiple sclerosis: this article details a study on tDCS in 25 MS patients, who used tDCS while playing a computer game.

Another MS tDCS study found that tDCS improves the fatigue in MS, when applied to the motor cortex of the brain

This MS study found no difference between tDCS and sham (a control condition where people think they're getting tDCS but aren't). Its a wonder it got published - the abstract is quite misleading.

At least they had a sham condition - better than PACE in that way - but no use if you're going to ignore the results.

I can't comment on the other MS one - you've only given a press release. Best not to put too much store in what press releases say. You can see from what they say about CBT and GET that they don't always have it right.

The military one is pretty solid. But remember that this is a very different use of tDCS - over the space of a couple of hours - and demonstrates only very short-lived effects.

 

[Hip]

This MS study found no difference between tDCS and sham (a control condition where people think they're getting tDCS but aren't). Its a wonder it got published - the abstract is quite misleading.

Are you referring to this 2014 Italian study: Transcranial direct current stimulation (tDCS) for fatigue in multiple sclerosis?

Can you quote the bit of text saying there was no difference between real tDCS and sham tDCS please, as I could not find a free full text version, not even on Sci Hub.


The other MS study mentioned in the article is this 2017 one: Remotely Supervised Transcranial Direct Current Stimulation Increases the Benefit of At-Home Cognitive Training in Multiple Sclerosis

The military one is pretty solid. But remember that this is a very different use of tDCS - over the space of a couple of hours - and demonstrates only very short-lived effects.

My thoughts are that tDCS may only offer a palliative effect on ME/CFS cognitive functioning, rather than address the core pathophysiology of the disease. tDCS boosts cognitive functioning in healthy people, so may work for ME/CFS as well, which would be useful for combating brain fog.

I am going to be making my own tDCS device shortly, out of a couple of pieces of wet saline soaked sponge to act as electrodes, a battery, and an electrical multimeter to monitor the current (I don't want to pay the $99 to $250 for the Focus tDCS device, as it may not work, and will then be a waste of money).

 

[Woolie]

Are you referring to this 2014 Italian study: Transcranial direct current stimulation (tDCS) for fatigue in multiple sclerosis?

Can you quote the bit of text saying there was no difference between real tDCS and sham tDCS please, as I could not find a free full text version, not even on Sci Hub.

You can get the fulltext here.

Its not easy to tease out the key information unless you do this stuff every day. You have to look at Table 2 (above). Low scores mean less fatigue. It is tricky to find the data, for two reasons. First, they have divided their sample into "responders" and "non responders" before reporting the data. This is a trick designed to make the results look better - its a way of taking out the inconvenient people who didn't do what you wanted. This sort of thing should be exploratory only, it should never be used for presenting the primary results.

Second, they have reported not just the baseline scores (T0) and the primary endpoint scores (T1), which is right after the course treatment, but also scores for the follow-up testing (T2 and T3), and hidden the key sham-tDCS comparisons by presenting the relevant results in entirely separate columns. So its hard to make out the key comparisons.

You would expect effects of tDCS to be highest immediately after the course of treatment, at T1. If you combine together the responders and non-responders, you get no overall difference between tDCS and Sham at T1. The "responders" get a tiny bit better in the tDCS condition (relative to sham), but the "non-responders" get quite a bit worse.

Remember that dividing into responders and non-responders assumes there is something being responded to. But you have to demonstrate this first. Otherwise you're just dividing up people based on random fluctuation in their data, and you can make anything look significant that way - your are just taking out the people who didn't do what you wanted.

If you have a completely inert treatment, what you would expect if you divide your group is that "responders" (people that apparently improved after your inert treatment) will indeed improve (you set it up that way), but "nonresponders" will get worse on your treatment. This pattern is a sure sign that the data are just random fluctuations around a baseline, and not genuine treatment-related improvement.

The pattern here is fully consistent with a null effect for tDCS.

 

[Woolie]

The other MS study mentioned in the article is this 2017 one: Remotely Supervised Transcranial Direct Current Stimulation Increases the Benefit of At-Home Cognitive Training in Multiple Sclerosis

I had a look at the other link you provided, @Hip. No sham condition at all.

No sham, no dice, sorry.

 

[Hip]

Thanks @Woolie for that user-friendly and nicely pedagogic explanation of the study. I am going to read and contemplate it more tomorrow, when I hope my brain will be clearer (I'm quite tired today); I think I will be able to learn something from it, in terms of how to properly analyze papers.

 

[alex3619]

And probably the most vulnerable of them all.

My understanding is that many brain neurons are very sensitive to low energy states. Its why some genetic disorders impacting energy first show up as hearing loss.

 

[niccon]

Hello all,

@Hip, did you make the tDCS device, and have you used it?

Thanks!

 

[Hip]

@Hip, did you make the tDCS device, and have you used it?

Yes, I did some tests with a home-made tDCS device, applying 0.4 milliamps of direct current across my temples for around 15 minutes daily.

This is well below what the maximum safe tDCS current of 4 mA.

I noticed the tDCS would prevent me from falling asleep for my usual 60 to 90 minute midday siesta. It almost has a caffeine-like effect of keeping your awake.

But I did not like this, because my midday sleep tends to refresh and reinvigorate my mind, and helps me order my thoughts, just like any sleep does. That siesta then sets me up for a productive second half of the day.

So I did not really like the sort of energy tDCS was giving me, disrupting my siesta.

But it may be a case of timing, as I was doing the tDCS midday, about the time I would normally fall asleep for a nap. Maybe if I did the tDCS in the morning, the slight stimulant effect would wear off by the time it got to my siesta time.

I did not notice any reduction in brain fog or other ME/CFS symptoms, but I only tested tDCS for about a week or so,


On the plus side, I found tDCS helped reduce the very mild psychosis-type mental health symptoms I sometimes get. I think tDCS also helps clear the depression I often get, and had a mild mood-boosting effect, but I did not test sufficiently to confirm and be certain about this.


This post lists the supplements and drugs which I have found effective for treating my depression.

 

[Hip]

You might also like this thread, @niccon, detailing a Japanese study which claims that microcurrent-range electric current therapy on neck and shoulders to fix a stiff neck cures ME/CFS.

 

[Alvin2]

current therapy on neck and shoulders to fix stiff neck cures ME/CFS.

How many ME/CFS cures are out there, could be in the millions, from homeopathy to autovaccines to KPAX to stem cells, to GET/CBT to magic beans and more.

 

[niccon]

@Hip Thanks Hip!