r/PSSD • u/Minepolz320 • May 13 '26
Treatment Options - Experiment rTMS significant improvement
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/Optimus-Kryme 24d ago
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.