Neuromodulation : journal of the International Neuromodulation Society
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Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is an emerging form of adjunctive therapy in focal refractory epilepsy. Unlike conventional DBS targets, the ANT is both encapsulated by white matter layers and located immediately adjacent to the cerebrospinal fluid (CSF) space. Owing to the location of the ANT, implantation has most commonly been performed using a transventricular trajectory. Previous studies suggest different electrical conductivity between gray matter, white matter, and CSF. ⋯ Valuable information can be obtained from the noninvasive measurement of therapeutic impedances. The selection of active contacts to target stimulation to the anterior nucleus may be guided by therapeutic impedance measurements to optimize outcome.
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We hypothesized that the laparoscopic implantation of neuroprosthesis (LION) procedure would significantly alter the body composition of patients with chronic traumatic spinal cord injury (SCI). The objectives were to determine the effect of the LION procedure on lean mass (LM), fatty mass (FM), and bone mineral content (BMC) in patients with SCI. ⋯ The LION procedure and subsequent neurostimulation procedures resulted in substantial increases in leg LM in patients with chronic traumatic SCI and paraplegia. A possible incremental effect on total BMC also was observed. Further studies are needed to confirm and expand these promising results.
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A market-released deep brain stimulation (DBS) lead and burr hole device (BHD) have been used for more than ten years to provide stable DBS therapy using leads with four equally distributed cylindrical electrodes along the distal lead length. Newer directional leads cluster segmented electrodes at the center of the electrode array. This work tests the hypothesis that improved chronic translational and rotational stability through enhanced BHD design may ensure that these newer directional electrodes remain in a stable orientation near the stimulation target to maintain therapy and maximize opportunities to adjust therapy, if needed. ⋯ These measurements quantitatively demonstrate that DBS system design can positively improve lead translational and rotational stability and show that system design is an important consideration for future product development.
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The purpose of this study was to evaluate analgesic and safety considerations for high thoracic and cervical dorsal root ganglion (DRG) neuromodulation for complex regional pain syndrome (CRPS). We hypothesized that DRG neuromodulation would provide sustained analgesia with complications like that of low thoracic or lumbar electrode implantation. ⋯ DRG neuromodulation for patients with CRPS of the upper extremities produced clinically important analgesia and reduced opioid use for ≥ six months but was associated with one serious complication.
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Symmetric biphasic pulses enlarge the therapeutic window in thalamic deep brain stimulation in patients with essential tremor. Adding an interphase gap to these symmetric biphasic pulses may further affect the therapeutic window. ⋯ The Clinicaltrials.gov registration number for the study is NCT05177900.