Neuromodulation : journal of the International Neuromodulation Society
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Multicenter Study
Rechargeable vs. nonrechargeable internal pulse generators in the management of dystonia.
To test if deep brain stimulation (DBS) treatment of dystonia was similar in patients before and after implantation of rechargeable internal pulse generators (IPGs). ⋯ Rechargeable IPGs should be the IPGs of choice for dystonic patients receiving DBS as IPGs offer similar treatment efficacy to nonrechargeable IPGs with advantages in terms of costs and reductions in reimplantation frequency.
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Multicenter Study
Rate of complications among the recipients of intrathecal baclofen pump in Japan: a multicenter study.
To evaluate the incidence of complications of intrathecal baclofen (ITB) therapy for spasticity in Japan, where a unique training course and nationwide registration are required. ⋯ The requirement of taking of a training course before starting ITB seemed to reduce complications. Although there were surgery-related complications, the rate of complications in Japan appeared to be lower than those reported in larger series of ITB. However, whether the reported rates can be primarily ascribed to a mandatory training course requires further investigations.
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The optimal target location of deep brain stimulation (DBS) is the subject of some controversy. We implanted electrodes that could stimulate both posterior subthalamic area (PSA) and ventralis intermedius nucleus of thalamus (Vim), and examined the benefits of bilateral DBS of Vim, PSA, and Vim + PSA in patients with essential tremor (ET). ⋯ We were able to identify the optimal electrode placement site for each patient based on his or her individualized response to the stimulation. Overall, there was no statistically significant difference among the DBS sites in terms of the benefits afforded by the stimulation. We propose that our technique may be a useful surgical method to treat ET.
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High-intensity and high-frequency repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex was carried out in poststroke patients with increased spasticity, and the changes in F-wave parameters in comparison with M-wave parameters induced by rTMS were examined. ⋯ High-frequency suprathreshold rTMS may suppress the F-waves by enhancing the inhibitory effect on spinal excitability through the corticospinal tract, and F-wave persistence and F/M Amp.Ratio can be used to determine the effect of rTMS on patients with increased spasticity.
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To investigate whether spinal cord stimulation (SCS) has a negative effect on static balance and gait, which is implicated by the increased incidence of falls leading to frequently occurring lead migrations. ⋯ The lack of group differences in normal gait and static balance cannot explain the increased incidence of falls. However, four subjects showed an effect of SCS on static balance. Further research to clarify why only a part of the subjects experienced balance problems is recommended and assessments of more demanding balance and gait tasks are desirable.