Non-invasive neuromodulation (NINM)
The latest Technology to improve Depression, Anxiety, Tinnitus, Post concussive symptoms, PTSD, Neuropathic pain and other illness.
neuromodulation header

NON-INVASIVE NEUROMODULATION (NINM) TRAINING IS AN ADVANCED LEVEL OF
NEUROREHABILITATION THERAPY

It combines brain stimulation with neuromuscular and cognitive re-education
Neuromodulation is a technology that acts directly upon nerves. It is the alteration—or modulation—of nerve activity by delivering electrical or pharmaceutical agents directly to a target area. Neuromodulation devices can stimulate a response where there was previously none.

Neurostimulation devices involve the application of electrodes to the brain, the spinal cord or peripheral nerves.

How are we different?

Our approach challenges the traditional practice of rehabilitation medicine.

The integrated NINM (non Invasive Neuromodulation) therapy proposed here aims to restore function beyond traditionally expected limits by employing both newly developed and novel therapeutic mechanisms for progressive physical and cognitive training – while simultaneously applying brain stimulation through a neurostimulation device.

Because Neurological conditions are a far more complex and multi factorial problem to treat than orthopedic conditions, effecting functional recovery will require different, elaborated and also multi factorial stimulation, control and related therapeutic paradigms.

neuromodulation wand

Vagal Nerve Stimulation (VNS)
The vagus nerve is located abreast the main neck arteries. Its ganglia are placed in the brain stem and are common with the tong-pharyngeal nerve. They have wide connections with the hypothalamus, rhinal system, and reticular formation. The pair of IX and X cranial nervous branches jointly implements parasympathetic innervation of the majority of human organs. Together with branches of vagus nerve, ones of the neck part of the sympathetic stem form several nervous interlacing in the heart region.

By this, the autonomic regulation of the heart activity is implemented. The nervous formations of neck area are tightly joined with brain stem, middle brain, cerebellum, thalamus, hypothalamus, and the large brain cortex. Presence thalamus, hypothalamus, and the large brain cortex. Presence of these connections provides participation of the neck nervous formations in analysis of irritations from sensors and in regulation of the muscle tonus, autonomic and the highest integrative functions .

Taking into account the mentioned facts, it is perspective to use the neck neuraxis nervous interlacing and the X and IX cranial nerves as a target for electro-stimulation. It will allow one to stimulate (through the afferent paths) the grey matter of the brain stem. (V.S. Kublanov, T.S. Petrenko, M.V. Babich).

Indications and Field of Research
Functional disorders of the Central Nervous system (CNS) and / or the Vagal Nerve Stimulation (VNS) :
  • Trauma or stroke
  • Epilepsy
  • Chronic headache
  • Somatoform disorders
  • Disorders of autonomic nervous system
  • Hypertension and its consequences
We are using this device only in a research context

Transcranial Direct Current Stimulation (tDCS)
Transcranial direct current stimulation (tDCS), is a non-invasive, painless brain stimulation treatment that uses direct electrical currents to stimulate specific parts of the brain.

Recent studies support a therapeutic potential of tDCS in patients with chronic neuropathic pain, Parkinson, stroke recovery, tinnitus (ringing in the ears), traumatic spinal cord injury, depression and other illnesses. tDCS has not been approved by the FDA for any therapeutic applications, thus treatments are considered an “off-label” application.

A constant, low intensity current is passed through two electrodes placed over the head which modulates neuronal activity. There are two types of stimulation with tDCS: anodal and cathodal stimulation.

Anodal stimulation acts to excite neuronal activity while cathodal stimulation inhibits or reduces neuronal activity.

Although tDCS is still an experimental form of brain stimulation, it potentially has several advantages over other brain stimulation techniques. It is cheap, non-invasive, painless and safe. It is also easy to administer and the equipment is easily portable.

Several studies suggest it may be a valuable tool for the treatment of neuropsychiatric conditions such as depression, anxiety, Parkinson’s disease, and chronic pain. Research has also demonstrated cognitive improvement in some patients undergoing tDCS. Currently, tDCS is not an FDA-approved treatment.

•  Watch this Video from PBS Newshour On the Soterix Medical tDCS device features

How a gentle electrical jolt can focus the sluggish mind

This procedure is approved by Health Canada

At The Montreal Neurotherapy Center, we use various non invasive type of brain stimulation in combination with specific training:
  • Repetitive Transcranial Magnetic Stimulation (rTMS)- Health Canada approved
  • Cranial Nerve Noninvasive Neuromodulation (CN-NINM) – Investigational use
  • Transcranial direct current stimulation (tDCS) - Health Canada approved
  • Non Invasive Vagal Nerve stimulation (VNS)- Investigational use
  • Non Invasive Spinal Cord Stimulation - Investigational use
neuromodulation neuron

Transcranial Magnetic Stimulation (rTMS)
rTMS is a procedure in which cerebral electrical activity is influenced by a pulsed magnetic field. The magnetic field is generated by passing brief current pulses through a figure 8 coil. This coil is encased in plastic and is held close to the scalp so that the magnetic field can be focused onto specific areas of the cortex, or surface, of the brain.

rTMS therapy is approved by FDA & Health Canada for clinical use.

The magnetic field that is generated in rTMS can penetrate the scalp and skull safely and painlessly to induce a current in specific regions of the brain. It is termed repetitive TMS, or rTMS, because the magnetic stimulation is delivered at regular intervals.

See this Video on rTMS from Boston University



Many aspects of rTMS, referred to as stimulation parameters, can be changed. The ability to change parameters while directly targeting specific brain areas suggests that rTMS has valuable therapeutic potential.

This means that the delivery of rTMS therapy may be customized for each patient. It also suggests that rTMS may be used to elicit certain desired effects in the brain (i.e. excitatory or inhibitory effects) that have shown promise for treating various conditions or illnesses such as:
  • Depression
  • Anxiety
  • Tinnitus
  • Post concussive symptoms
  • PTSD
  • Neuropathic pain

neuromodulation neck rtmsThe portable corrector of activity of the Sympathetic Nervous System (SYMPATHOCOR) is an electrical pulse generator that delivers the spatially-distributed field of the carefully-controlled current pulses in the neck (Kublanov V.S., 2008).

neuromodulation neck rtms device
SYMPATHOCORRECTION Technology is a method of the dynamic correction of the activity sympathetic nervous system is used for the neck neuro-stimulation in limits of the “homeostatic corridor,” under which the vegetative regulation is not violated (Kublanov V.S., Danilova I.G., Goette I.F., et al., 2010).

Publications on rTMS for Physicians

rTMS Publication

  1. Bickford RG, Guidi M, Fortesque P, Swenson M. Magnetic stimulation of human peripheral nerve and brain: response enhancement by combined magnetoelectrical technique. Neurosurgery. 1987;20(1):110-6.
  2. Pascual-Leone A, Rubio B, Pallardo F, Catala MD. Rapid-rate transcranial magnetic stimulation of left dorsolateral prefrontal cortex in drug-resistant depression. Lancet. 1996;348(9022):233-7.
  3. Fava M. Diagnosis and definition of treatment-resistant depression. Biol Psychiatry. 2003;53(8):649-59.
  4. Patten SB, Wang JL, Williams JV, Currie S, Beck CA, Maxwell CJ, et al. Descriptive epidemiology of major depression in Canada. Can J Psychiatry. 2006;51(2):84-90.
  5. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;289(23):3095-105.
  6. Trivedi MH, Rush AJ, Wisniewski SR, Nierenberg AA, Warden D, Ritz L, et al. Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. Am J Psychiatry. 2006;163(1):28-40.
  7. Nemeroff CB. Prevalence and management of treatment-resistant depression. J Clin Psychiatry. 2007;68(Suppl 8):17-25.
  8. Wassermann EM, Zimmermann T. Transcranial magnetic brain stimulation: therapeutic promises and scientific gaps. Pharmacol Ther. 2012;133(1):98-107.
  9. Rossi S, Hallett M, Rossini PM, Pascual-Leone A, Safety of TMSCG. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009;120(12):2008-39.
  10. Wassermann EM. Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5-7, 1996. Electroencephalogr Clin Neurophysiol. 1998;108(1):1-16.
  11. Lefaucheur JP, Andre-Obadia N, Poulet E, Devanne H, Haffen E, Londero A, et al. [French guidelines on the use of repetitive transcranial magnetic stimulation (rTMS): safety and therapeutic indications]. Neurophysiol Clin. 2011;41(5-6):221-95.
  12. Enns MW, Reiss JP. Electroconvulsive therapy. Ottawa, ON [Internet]. Canadian Psychiatric Association; 2001 [cited 2015 April 9]. Available from: https://ww1.cpa-apc.org/Publications/Position_Papers/Therapy.asp
  13. Nahas Z, Lomarev M, Roberts DR, Shastri A, Lorberbaum JP, Teneback C, et al. Unilateral left prefrontal transcranial magnetic stimulation (TMS) produces intensity-dependent bilateral effects as measured by interleaved BOLD fMRI. Biol Psychiatry. 2001;50(9):712-20.
  14. Cusin C, Yang H, Yeung A, Fava M. Rating scales for depression. In: Baer L, Blais MA, editors. Handbook of clinical rating scales and assessment in psychiatry and mental health. Boston (MA): Humana Press; 2010. p. 7-35.
  15. Mogg A, Pluck G, Eranti SV, Landau S, Purvis R, Brown RG, et al. A randomized controlled trial with 4-month follow-up of adjunctive repetitive transcranial magnetic stimulation of the left prefrontal cortex for depression. Psychol Med. 2008;38(3):323-33.
  16. McIntyre RS, Konarski JZ, Mancini DA, Fulton KA, Parikh SV, Grigoriadis S, et al. Measuring the severity of depression and remission in primary care: validation of the HAMD-7 scale. CMAJ. 2005;173(11):1327-34.
  17. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557-60.
  18. Guyatt GH, Oxman AD, Schunemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol. 2011;64(4):380-2.
  19. Padberg F, Zwanzger P, Keck ME, Kathmann N, Mikhaiel P, Ella R, et al. Repetitive transcranial magnetic stimulation (rTMS) in major depression: relation between efficacy and stimulation intensity. Neuropsychopharmacology. 2002;27(4):638-45.
  20. Rosa MA, Gattaz WF, Pascual-Leone A, Fregni F, Rosa MO, Rumi DO, et al. Comparison of repetitive transcranial magnetic stimulation and electroconvulsive therapy in unipolar non-psychotic refractory depression: a randomized, single-blind study. Int J Neuropsychopharmacol. 2006;9(6):667-76.
  21. Stern WM, Tormos JM, Press DZ, Pearlman C, Pascual-Leone A. Antidepressant effects of high and low frequency repetitive transcranial magnetic stimulation to the dorsolateral prefrontal cortex: a double-blind, randomized, placebo-controlled trial. J Neuropsychiatry Clin Neurosci. 2007;19(2):179-86.
  22. Blumberger DM, Mulsant BH, Fitzgerald PB, Rajji TK, Ravindran AV, Young LT, et al. A randomized double-blind sham-controlled comparison of unilateral and bilateral repetitive transcranial magnetic stimulation for treatment-resistant major depression. World J Biol Psychiatry. 2012;13(6):423-35.
  23. Fitzgerald PB, Brown TL, Marston NA, Daskalakis ZJ, De Castella A, Kulkarni J. Transcranial magnetic stimulation in the treatment of depression: a double-blind, placebo-controlled trial. Arch Gen Psychiatry. 2003;60(10):1002-8.
  24. Hoppner J, Schulz M, Irmisch G, Mau R, Schlafke D, Richter J. Antidepressant efficacy of two different rTMS procedures. High frequency over left versus low frequency over right prefrontal cortex compared with sham stimulation. Eur Arch Psychiatry Clin Neurosci. 2003;253(2):103-9.
  25. Mosimann UP, Schmitt W, Greenberg BD, Kosel M, Muri RM, Berkhoff M, et al. Repetitive transcranial magnetic stimulation: a putative add-on treatment for major depression in elderly patients. Psychiatry Res. 2004;126(2):123-33.
  26. Avery DH, Holtzheimer PE, 3rd, Fawaz W, Russo J, Neumaier J, Dunner DL, et al. A controlled study of repetitive transcranial magnetic stimulation in medication-resistant major depression. Biol Psychiatry. 2006;59(2):187-94.
  27. George MS, Lisanby SH, Avery D, McDonald WM, Durkalski V, Pavlicova M, et al. Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial. Arch Gen Psychiatry. 2010;67(5):507-16.
  28. Loo C, Mitchell P, Sachdev P, McDarmont B, Parker G, Gandevia S. Double-blind controlled investigation of transcranial magnetic stimulation for the treatment of resistant major depression. Am J Psychiatry. 1999;156(6):946-8.
  29. Loo CK, Mitchell PB, McFarquhar TF, Malhi GS, Sachdev PS. A sham-controlled trial of the efficacy and safety of twice-daily rTMS in major depression. Psychol Med. 2007;37(3):341-9.
  30. O'Reardon JP, Solvason HB, Janicak PG, Sampson S, Isenberg KE, Nahas Z, et al. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry. 2007;62(11):1208-16.
  31. Bakim B, Uzon UE, Karamustafalioglu O, Ozcelik B, Alpak G, Tankaya O, et al. The combination of antidepressant drug therapy and high frequency repetitive transcranial magnetic stimulation in medication-resistant depression. Klin Psikofarmakol B. 2012;22(3):244-53.
  32. Su TP, Huang CC, Wei IH. Add-on rTMS for medication-resistant depression: a randomized, double-blind, sham-controlled trial in Chinese patients. J Clin Psychiatry. 2005;66(7):930-7
  33. Berman RM, Narasimhan M, Sanacora G, Miano AP, Hoffman RE, Hu XS, et al. A randomized clinical trial of repetitive transcranial magnetic stimulation in the treatment of major depression. Biol Psychiatry. 2000;47(4):332-7.
  34. Boutros NN, Gueorguieva R, Hoffman RE, Oren DA, Feingold A, Berman RM. Lack of a therapeutic effect of a 2-week sub-threshold transcranial magnetic stimulation course for treatment-resistant depression. Psychiatry Res. 2002;113(3):245-54.
  35. Bretlau LG, Lunde M, Lindberg L, Unden M, Dissing S, Bech P. Repetitive transcranial magnetic stimulation (rTMS) in combination with escitalopram in patients with treatment-resistant major depression: a double-blind, randomised, sham-controlled trial. Pharmacopsychiatry. 2008;41(2):41-7.
  36. Garcia-Toro M, Mayol A, Arnillas H, Capllonch I, Ibarra O, Crespi M, et al. Modest adjunctive benefit with transcranial magnetic stimulation in medication-resistant depression. J Affect Disord. 2001;64(2-3):271-5.
  37. Triggs WJ, Ricciuti N, Ward HE, Cheng J, Bowers D, Goodman WK, et al. Right and left dorsolateral pre-frontal rTMS treatment of refractory depression: a randomized, sham-controlled trial. Psychiatry Res. 2010;178(3):467-74.
  38. Holtzheimer PE, 3rd, Russo J, Claypoole KH, Roy-Byrne P, Avery DH. Shorter duration of depressive episode may predict response to repetitive transcranial magnetic stimulation. Depress Anxiety. 2004;19(1):24-30.
  39. Chen SJ, Chang CH, Tsai HC, Chen ST, Lin C. Superior antidepressant effect occurring 1 month after rTMS: add-on rTMS for subjects with medication-resistant depression. Neuropsychiatr Dis Treat. 2013;9:397-401.
  40.  Fitzgerald PB, Hoy KE, Herring SE, McQueen S, Peachey AV, Segrave RA, et al. A double blind randomized trial of unilateral left and bilateral prefrontal cortex transcranial magnetic stimulation in treatment resistant major depression. J Affect Disord. 2012;139(2):193-8.
  41. Avery DH, Claypoole K, Robinson L, Neumaier JF, Dunner DL, Scheele L, et al. Repetitive transcranial magnetic stimulation in the treatment of medication-resistant depression: preliminary data. J Nerv Ment Dis. 1999;187(2):114-7.
  42. Cuijpers P, Sijbrandij M, Koole SL, Andersson G, Beekman AT, Reynolds CF, 3rd. Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis. World Psychiatry. 2014;13(1):56-67.
  43. Eranti S, Mogg A, Pluck G, Landau S, Purvis R, Brown RG, et al. A randomized, controlled trial with 6-month follow-up of repetitive transcranial magnetic stimulation and electroconvulsive therapy for severe depression. Am J Psychiatry. 2007;164(1):73-81.
  44.  Grunhaus L, Dannon PN, Schreiber S, Dolberg OH, Amiaz R, Ziv R, et al. Repetitive transcranial magnetic stimulation is as effective as electroconvulsive therapy in the treatment of nondelusional major depressive disorder: an open study. Biol Psychiatry. 2000;47(4):314-24.
  45. Grunhaus L, Schreiber S, Dolberg OT, Polak D, Dannon PN. A randomized controlled comparison of electroconvulsive therapy and repetitive transcranial magnetic stimulation in severe and resistant nonpsychotic major depression. Biol Psychiatry. 2003;53(4):324-31.
  46. Keshtkar M, Ghanizadeh A, Firoozabadi A. Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for the treatment of major depressive disorder, a randomized controlled clinical trial. J ECT. 2011;27(4):310-4.
  47. Pridmore S, Bruno R, Turnier-Shea Y, Reid P, Rybak M. Comparison of unlimited numbers of rapid transcranial magnetic stimulation (rTMS) and ECT treatment sessions in major depressive episode. Int J Neuropsychopharmacol. 2000;3(2):129-34
  48. Dannon PN, Dolberg OT, Schreiber S, Grunhaus L. Three and six-month outcome following courses of either ECT or rTMS in a population of severely depressed individuals--preliminary report. Biol Psychiatry. 2002;51(8):687-90.
  49. Schutter DJ. Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis. Psychol Med. 2009;39(1):65-75.
  50. Lam RW, Chan P, Wilkins-Ho M, Yatham LN. Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and metaanalysis. Can J Psychiatry. 2008;53(9):621-31.
  51. Couturier JL. Efficacy of rapid-rate repetitive transcranial magnetic stimulation in the treatment of depression: a systematic review and meta-analysis. J Psychiatry Neurosci. 2005;30(2):83-90.
  52. Berlim MT, van den Eynde F, Tovar-Perdomo S, Daskalakis ZJ. Response, remission and drop-out rates following high-frequency repetitive transcranial magnetic stimulation (rTMS) for treating major depression: a systematic review and meta-analysis of randomized, double-blind and sham-controlled trials. Psychol Med. 2014;44(2):225-39.
  53. Berlim MT, Van den Eynde F, Daskalakis ZJ. Efficacy and acceptability of high frequency repetitive transcranial magnetic stimulation (rTMS) versus electroconvulsive therapy (ECT) for major depression: a systematic review and meta-analysis of randomized trials. Depress Anxiety. 2013;30(7):614-23.
  54. Kedzior KK, Reitz SK, Azorina V, Loo C. Durability OF the antidepressant effect of the high-frequency repetitive transcranial magnetic stimulation (rTMS) In the absence of maintenance treatment in major depression: a systematic review and meta-analysis of 16 double-blind, randomized, sham-controlled trials. Depress Anxiety. 2015;32(3):193-203.
  55. Nahas Z, Li X, Kozel FA, Mirzki D, Memon M, Miller K, et al. Safety and benefits of distance-adjusted prefrontal transcranial magnetic stimulation in depressed patients 55-75 years of age: a pilot study. Depress Anxiety. 2004;19(4):249-56.
  56. Daskalakis ZJ, Levinson AJ, Fitzgerald PB. Repetitive transcranial magnetic stimulation for major depressive disorder: a review. Can J Psychiatry. 2008;53(9):555-66.
  57. Fregni F, Marcolin MA, Myczkowski M, Amiaz R, Hasey G, Rumi DO, et al. Predictors of antidepressant response in clinical trials of transcranial magnetic stimulation. Int J Neuropsychopharmacol. 2006;9(6):641-54.



Non Invasive Spinal Cord Stimulation
neuromodulation spinal

A new technique called trans-cutaneous stimulation


The device help restore optimal physiology function in individuals suffering with paralysis due to injury and illness. We accomplish this by enabling the reactivation of damaged and dormant neural circuits through neuromodulation of the spinal cord. The method we use is to apply our a stimulator technology below the level of injury targeting neural connections & pathways with pre set stimulation parameters enabling the spinal cord to re-awaken and recall what it is suppose to do.

This device is used for research only

More info on Neuro Recovery Technologies

Passive Infrared Hemoencephalography (pIR HEG)

What is Passive Infrared (pIR HEG)?

PASSIVE INFRARED HEMOENCEPHALOGRAPHY refers to a variant of that technique. It utilizes physiological signals from the brain, but these signals are based on thermal output, arising from changes in blood flow dynamics and cellular metabolism.

How Does pIR-HEG Neurofeedback Work?

Blood flow is increased at the prefrontal cortex with attentional brain activity. By achieving focused attention with a relaxed body and mind, the neurofeedback participant is able manipulate the computer sensor output that is measuring blood flow. The trainee learns how to increase activation of important brain activities and eventually can retrain the brain to perform better.

The Passive Infrared (pIR HEG) process is simple to learn and often enjoyable.





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GENERAL INFORMATION

Neuromodulation General Information

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VIDEOS - MEDIAS

Neuromodulation Videos & Medias

Dr. Norman Doidge | The Power of Thought
Dr. Norman Doidge | The Power of Thought
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LITERATURE - RESEARCH

Neuromodulation Literature - Research

Bibliography for Physicians on tDCS

tDCS for Fibromyalgia

tdcs-fibromyalgia

tDCS for Other Pain


LINKS & REFERENCES

I think we're all fascinated and a little mystified by how the brain works. One of the most mysterious of the physical sciences is neurological science. 

From: Alexis Denisof

Improve Brain Stimulation & Neuromuscular and Cognitive Re-education
Our Highly Qualified Team used the latest technologies and Proved Medical Researchs...

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Contacts & Location

Opening Hours

Monday to Friday: 9 AM – 5 PM
Saturday: 9 AM – 3 PM
Sunday: Closed

General Inquiries

Tel: (514) 481-7867
Toll Free: 1 866.331-3431
Email:
Fax: (514) 933-6318 

Find Us!

3400 Jean-Talon Ouest,
Suite 100 Montreal, QC
H3R 2E8


metro   bus  handicap

Google Map

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