Call Us today

Tri-Cities:509-420-5060
Bellevue: 425-326-1662

Our Services


Electroconvulsive therapy

Electroconvulsive therapy is more popular as electric shock treatment. This is one of the brain stimulation psychiatric treatment options for the people with treatment resistant major depression. In this procedure controlled electric currents are passed through the brain with intentionally prompting a brief seizure. ECT brings changes in the brain chemistry to reverse the symptoms of depression. Given to patients under general anesthesia.


Advantages:

  • One of the fastest ways to relieve symptoms in severely depressed or suicidal patients
  • Severe mania
  • Treatment resistant depression
  • Catatonia
  • Agitation
  • Severe depression in pregnancy
  • Treatment resistant mania

Disadvantages:

  • Memory loss for few days to few months
  • Confusion for few minutes to few hours after the procedure
  • Nausea, vomiting, muscle spasms, headache, rarely fracture limbs
  • General anesthesia risks




TMS

TMS (Transcranial Magnetic Stimulation) therapy was recently FDA-approved for patients suffering from major depression who have not benefited from prior anti-depressant treatment. This form of therapy is non-invasive which works quickly and efficiently to accommodate your schedule. During a professionally monitored procedure which generally lasts around forty minutes, TMS gently sends a pulsed electrical current to specific areas of the brain believed to be involved in mood regulation. The goal of Reliance TMS Therapy is to allow you to feel the pulsations of hope and renewal coursing through your everyday activities once again. It can be the beginning step towards a positive outlook on the possibly forgotten beauty of life.


Benefits:

  • TMS Therapy is highly effective based off of clinical research. It has even been considered more effective and beneficial based off of success rates than Pharmacotherapy Intervention and Electroconvulsive Therapy (ECT).
  • TMS Therapy does not have the systematic side effects like those that other anti-depressant drugs cause such as, weight gain, sexual dysfunction, nausea, dry mouth, sedation, and others. The only reported discomfort is a minor-moderate headache, and redness/ sensitivity in the specified area on the scalp that was treated upon. Even these side effects were generally seen only within the first week of treatment and would taper off in the duration of treatment.
  • It is a painless procedure.
  • With TMS being a non-invasive, non-systematic procedure it could be considered more appealing to some patients compared to other therapies for depression.
  • It is an outpatient therapy.
  • There is a 0.1% chance for a patient to have a seizure in result of treatment. In over 10,000 clinical trials with the NeuroStar TMS system, there were no seizures reported.
  • Patients have the benefit of receiving reports regarding their progress and their results throughout the course of treatment.

Outline:

  • Pre-treatment Consultation:This initial consultation is to ensure that you are a suitable candidate for Reliance TMS therapy.
  • First Day of Treatment:Treatment is administered by a trained operating technician and overseen by your psychiatrist.
  • Duration:Depending on the patient’s individual needs, treatment protocol could consist of anywhere from 20-30 treatment sessions extended over a 4-6 week period, five times per week.
  • CommunicationReliance TMS Center staff members would like to know your feedback and enjoy learning how we can help your treatment experience be as comfortable as possible. Read More

QUANTITATIVE ELECTROENCEPHALOGRAM (QEEG)

Electroencephalography (EEG) is the measurement of electrical patterns at the surface of the scalp, which reflect cortical activity, and are commonly referred to as “brainwaves”.

Quantitative EEG (QEEG) is the analysis of the digitized EEG, and is sometimes referred to as “Brain Mapping”. The QEEG is an extension of the analysis of the visual EEG interpretation that may assist and even augment our understanding of the EEG and brain function.

Starting in the 1970s it became possible to store the EEG signals on computer media for later analysis. As computers and electronic amplifiers became smaller and faster, and as mathematical methods developed, it has become possible to store 19 or more channels of EEG data on a laptop computer using an amplifier the size of a hardback book. Often the sensors are attached to the inner surface of a cloth or mesh cap. The caps come in various sizes so that the sensors will be accurately placed on any size head.

The computer is capable of recognizing many more and subtle patterns among the brain waves in various locations than the eye can normally see. These patterns are then graphically displayed as colored brain maps, tables, and charts. Despite the impressive ability to detect subtle significant patterns, the raw EEG must always be analyzed by a trained eye in order to avoid misinterpretation or ambiguity in the QEEG.

A very special feature of modern QEEG is that all the data from a client's recording can be compared to several databases of 'normal' individual’s brainwaves. This makes it much easier to spot statistically significant deviations. These deviations may or not be clinically significant. It is important to consider them in light of any complaints or conditions the client might have in order to better appreciate their significance, if any.


How and why is QEEG used in Neurofeedback?

Much of the groundbreaking work in neurofeedback was done without the aid of QEEG. Many practitioners still use protocols that are generally but not always safe and provide the ability for most brains to develop flexibility and increased control. Studies (references to come) have suggested that for some populations QEEG-driven neurofeedback is more effective. The differences between what are commonly called EEG and QEEG is that EEG reading always involves deep attention to the raw EEG and perhaps a few quantified metrics such as peak frequency.

This is the form most commonly used in hospitals and neurology practices. Neurofeedback and research have particular interest in maps and charts that are completely made from mathematical measurements on the raw EEG. These so-called QEEG brain maps are often useful in developing strategies for neuromodulation.

How is QEEG performed?

The client's head is measured to determine which size sensor cap will be used. The caps are comfortable and it is easy and quick to prepare them to record a high-quality signal. The cap is plugged into a 32 channel Mitsar amplifier which is controlled by the WinEEG software www.novatecheeg.com. The sensors in the cap are optically isolated from the power to avoid any risk of shock. Once the EEG is obtained it can be analyzed further with the WinEEG software and the Human Brain Index database www.mitsar-medical.com or exported to be analyzed with the Neuroguide database www.appliedneuroscience.com or the Sterman-Kaiser SKIL database www.skiltopo.com.

The cap and its sensors must be positioned according to the International 10-20 system; the sensors must be prepped with special conductive gel and the connection of each sensor with the scalp must be tested; the client must be comfortable and watched for any unnecessary movements of body or hardware. Some time after capturing the EEG recording, it must be carefully examined by eye in order to judge its quality and any gross indicators of problems.

If the goal is to compare complex measurements of the client’s EEG with those of a database of expected values, then it will be necessary to carefully isolate just those sections of the recording that are free of “artifacts”. An artifact refers to a signal embedded in the scalp recording that comes from movement or the environment or is otherwise not related to brain electrical produced by a non-drowsy brain in a resting state. Usually such recordings include one or more taken with

  • 1) eyes opened
  • 2) eyes closed and sometimes
  • 3) during a task such as reading or calculating.



  • tDCS

    Transcranial direct current stimulation is a non-invasive, safe brain stimulation treatment for major depressive disorder, anxiety, chronic pain, Alzheimer’s, cognitive enhancement in health individuals, schizophrenia and Parkinson’s disease. In tDCS procedure a controlled low intensity current is passed through the electrodes to change the activity of brain chemical activity as well as neuronal activity.

    Disadvantages: Headache, nausea, dizziness, redness at the site of stimulation.




    QbCHECK

    QbCheck provides with objective measurements of hyperactivity, impulsivity, and inattention to aid in the assessments of ADHD and in the evaluation of treatment interventions in patients with ADHD. Only qualified professionals should interpret QbCheck results. QbCheck shall always be interpreted in combination with other clinically relevant information, such as clinical interview and/or standard symptom scales. QbCheck test will be taken at the computer.


    No medications, needles or physical contact is required. QbCheck requires a computer with web camera. Test involves a system check of the computer, instructions on how to perform a QbCheck, a practice test, a QbCheck and the presentation of results. Test taker sits on a chair with back support but no arm support. In taking the QbCheck test, test taker will watch and /or listen to certain information and prompts and will respond using a keyboard. QbCheck report will present an overall ADHD symptom level indicator score, scores of all three main symptoms of ADHD, a visual presentation of the test data and data for comparison. QbCheck test results are not intended to be a stand alone diagnosis of ADHD, rather test results will merely provide an indication of patient’s risk of having ADHD. No known contraindications for conducting QbCheck. View More