Neuromodulation : journal of the International Neuromodulation Society
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Case Reports
Spinal Cord Stimulation for the Treatment of Neuropathic Pain Associated With Leprosy: A Case Report.
Leprosy is a major source of nerve damage and may lead to neuropathic pain as well as complex regional pain syndrome (CRPS). Spinal cord stimulation is an effective treatment for CRPS, but there are no reports of this treatment in a patient with leprosy. ⋯ Spinal cord stimulation may be a valuable intervention for patients with leprosy-induced CRPS.
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Pain is one of the common symptoms in patients with Parkinson's disease (PD), with a prevalence of approximately 40-85%. These symptoms affect the quality of life of PD patients. We evaluated the effect of spinal cord stimulation (SCS) to chronic pain and motor symptoms of PD. ⋯ Our results indicate that SCS may be a treatment option for both motor symptoms and chronic pain in PD, especially in cases complicated with lumbar canal stenosis or disc herniation. Further studies are needed to evaluate the efficacy of SCS in PD patients.
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Review Multicenter Study
Long-Term Evaluation of Changes in Operative Technique and Hardware-Related Complications With Deep Brain Stimulation.
Deep brain stimulation is the most frequent neurosurgical procedure for movement disorders. ⋯ This large series of patients and long-term follow-up demonstrates that risks are very low in comparison with other neurosurgical procedures, but DBS is still an elective procedure that necessitates extensive care and precision. In a rapidly evolving field, attention to surgical technique is imperative and will keep rates of complications at a minimum.
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Review Case Reports
Early Use of 60 Hz Frequency Subthalamic Stimulation in Parkinson's Disease: A Case Series and Review.
Deep brain stimulation (DBS) is effective in treating the segmental symptoms of Parkinson's disease (PD) as well as axial symptoms that are levodopa responsive. PD patients on chronic DBS who develop axial symptoms and gait disturbances several years later oftentimes are refractory to high frequency stimulation (HFS). Several studies report benefit produced by low frequency subthalamic nucleus (STN) stimulation in such patients, though the sustainability of the effects has been mixed. ⋯ This case series demonstrates the clinical efficacy of utilizing low frequency (60 Hz) STN stimulation early in the DBS programming course in more advanced PD patients with levodopa responsive gait disturbance and freezing of gait. Activation of a broader stimulation field likely contributed to both axial and segmental symptom improvement while possibly aiding in the reduction of dyskinesia.
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Randomized Controlled Trial
Low-Frequency Repetitive Transcranial Magnetic Stimulation Targeted to Premotor Cortex Followed by Primary Motor Cortex Modulates Excitability Differently Than Premotor Cortex or Primary Motor Cortex Stimulation Alone.
The excitability of primary motor cortex (M1) can be modulated by applying low-frequency repetitive transcranial magnetic stimulation (rTMS) over M1 or premotor cortex (PMC). A comparison of inhibitory effect between the two locations has been reported with inconsistent results. This study compared the response secondary to rTMS applied over M1, PMC, and a combined PMC + M1 stimulation approach which first targets stimulation over PMC then M1. ⋯ The results indicate that PMC + M1 stimulation may modulate brain excitability differently from PMC or M1 alone. CSP was the assessment measure most sensitive to changes in inhibition and was able to distinguish between different inhibitory protocols. This work presents a novel procedure that may have positive implications for therapeutic interventions.