Neuromodulation : journal of the International Neuromodulation Society
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Review
Transcutaneous Tibial Nerve Stimulation in the Management of Overactive Bladder: A Scoping Review.
Overactive bladder (OAB) is a condition that has physical, social, psychosocial, and financial impacts. Transcutaneous tibial nerve stimulation (TTNS) is a modality that stimulates the nerve root fibers of L5-S3, the same spinal segments of the parasympathetic nervous system as the bladder. This scoping review aims to identify current literature available on the feasibility and outcomes of TTNS as a first-line treatment option for OAB. ⋯ TTNS is a promising first-line management option for people with OAB, particularly in the older population and for those with neurogenic bladder. It can provide symptomatic relief from urinary incontinence, frequency, urgency, and nocturia, while avoiding the bothersome side effects of more invasive or pharmaceutical therapies. Heterogeneity in treatment parameters limits generalizability and translation of the most appropriate clinical application and should be considered in future trials.
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Randomized Controlled Trial
Efficacy of Transcutaneous Electrical Nerve Stimulation and Interferential Current on Tactile Acuity of Individuals With Nonspecific Chronic Low Back Pain.
Transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) are pain electrotherapies with questioned efficacy. Studies of their effects on tactile acuity of individuals with nonspecific chronic low back pain (NSCLBP) are limited, hence, this study. ⋯ TENS increases the tactile acuity of individuals with NSCLBP, whereas IFC demonstrated no significant change in tactile acuity.
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Multicenter Study
Multicenter Study for the Effect of COVID-19 Lockdown on Patients With Sacral Neuromodulation Implants.
The massive spread of COVID-19 affected many aspects of medical and surgical services. Many patients with sacral neuromodulation (SNM) devices needed integrated follow-up and close communication regarding the programming of the device. In this study, we aimed to explore the effect of COVID-19 lockdown on patients with SNM devices. ⋯ The difficulties with access to care experienced during the pandemic and the patient's expressed willingness to participate in virtual care should provide impetus for manufacturers of SNM devices to move forward with developing remote programming capabilities.
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We consider two consequences of brain capillary ultrastructure in neuromodulation. First, blood-brain barrier (BBB) polarization as a consequence of current crossing between interstitial space and the blood. Second, interstitial current flow distortion around capillaries impacting neuronal stimulation. ⋯ BBB stimulation by principle 1 suggests novel therapeutic strategies such as boosting metabolic capacity or interstitial fluid clearance. Whereas the spatial profile of EBRAIN is traditionally assumed to depend only on macroscopic anatomy, principle 2 suggests a central role for local capillary ultrastructure-which impact forms of neuromodulation including deep brain stimulation (DBS), spinal cord stimulation (SCS), transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), and transcranial electrical stimulation (tES)/transcranial direct current stimulation (tDCS).
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Tinnitus has no reliable cure but may be significantly relieved by the usage of cochlear implants. However, not all tinnitus patients necessitate cochlear implantation that can impair hearing. This study was to investigate whether a novel extracochlear electrical stimulation (EES) strategy could relieve tinnitus of guinea pigs without hearing impairment, and the roles of auditory-somatosensory plasticity in the cochlear nucleus in the tinnitus relief. ⋯ This study demonstrated that the novel EES strategy could effectively relieve tinnitus without impairment to hearing and cochlear structure of tinnitus animals. The reversal of tinnitus-related auditory-somatosensory plasticity in the cochlear nucleus was correlated with the tinnitus relief induced by the EES.