Neuromodulation : journal of the International Neuromodulation Society
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Observational Study
Single-Center Experience With High-Density Spinal Cord Stimulation in Patients With Refractory Angina Pectoris.
Spinal cord stimulation (SCS) is a treatment option for patients with refractory angina pectoris (RAP) which was first used in 1987 and led to a reduction in the number of angina pectoris episodes, less consumption of short-acting nitrates, and an improvement in the quality of life. The conventional mode of stimulation leads to paresthesia felt at the target area. In recent years novel modes of stimulation have been developed that are paresthesia free, such as "burst," "high-density (HD)," or "high-frequency/10 kHz" stimulation. To date, these new modes of stimulation have not been used in patients with RAP and a spinal cord stimulator. This retrospective, single-center, observational study gives a description of the experience of using HD stimulation in selected patients with RAP being treated with SCS. ⋯ This retrospective study shows that the use of HD stimulation in patients with RAP being treated with SCS could be an alternative option for conventional stimulation. Due to the nature of this study, additional research is essential to confirm these initial findings.
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Observational Study
Insular Role in Blood Pressure and Systemic Vascular Resistance Regulation.
The insula is a brain area involved in the modulation of autonomic responses. Previous studies have focused mainly on its heart rate regulatory function, but its role in vascular control is not well defined. Ictal/postictal blood pressure (BP) fluctuations may have a role in the pathogenesis of sudden unexpected death in epilepsy. This study aims to characterize the insular influence on vascular regulation through direct high-frequency electrical stimulation (E-stim) of different insular regions during stereo-electroencephalographic studies. ⋯ Our findings on insular stimulation suggest an interhemispheric difference in its vascular regulatory function, with a vasopressor effect of the right insula and a vasodilator effect of the left one.
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This study explored intraneural stimulation of the right thoracic vagus nerve (VN) in sexually mature male minipigs to modulate safe heart rate and blood pressure response. ⋯ Heart rate modulation was obtained without inducing any observable adverse effects, underlining the high selectivity of the intraneural approach.
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This long-term retrospective study evaluated the survival and amputation outcome of subjects who received neuromodulation therapy for the management of peripheral arterial disease (PAD). ⋯ Our single-center data support the efficacy of spinal neuromodulation for improvements in limb salvage, pain relief, mobility, and quality of life. The data also show that neuromodulative therapy has a long-term therapeutic effect in patients with chronic limb pain with Rutherford category 3, 4, and 5 PAD.
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Autonomic nervous activity imbalance plays an important role in atrial fibrillation (AF). AF can be treated by acupuncture at the Neiguan point (PC6), but the mechanism remains elusive. Here, we investigated autonomic nervous system activity in electroacupuncture (EA) at PC6 in a rat AF model. ⋯ The protective effect of EA at PC6 on AF is associated with balance between sympathetic and vagal nerve activities.