Neuromodulation : journal of the International Neuromodulation Society
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Moderate-to-severe obstructive sleep apnea (OSA) affects a large segment of the US population and is characterized by repetitive and reversible obstruction of the upper airway during sleep. Untreated OSA is associated with increased incidence of heart attack, stroke, and motor vehicle accidents due to sleepiness. Continuous positive airway pressure is often prescribed, but most patients with OSA are nonadherent. One effective alternative is stimulation of the hypoglossal nerve (HGN) that acts to open and stiffen the airway. However, currently available HGN stimulators require major surgery to implant a pacemaker-like device and leads that connect to a cuff electrode encircling the HGN. In this study, we performed preliminary tests in rats and humans of a miniature stimulating device that, in the future, could be injected near the HGN with ultrasound guidance. ⋯ Collectively, these initial experiments encourage future studies to determine the utility of this system in alleviating OSA in human subjects.
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Chronic pelvic pain (CPP) is a multifaceted condition that poses significant challenges in clinical management owing to its complex and varied pathophysiology, including neuropathic, somatic, visceral, and musculoskeletal components. Endometriosis is frequently associated with CPP, necessitating a comprehensive, multimodal treatment strategy. This approach typically includes physical and behavioral therapy, pharmacologic interventions, surgical management of endometriosis, and various pain-modulating procedures. Neuromodulation, particularly spinal cord stimulation (SCS), has been used in refractory cases; however, its use is often met with limited success and a notable rate of explants. This case series presents nine patients with intractable CPP secondary to endometriosis, unresponsive to conventional treatments, who were treated with dorsal root ganglion stimulation (DRG-S). ⋯ Bilateral L1 and S2 DRG-S yielded robust and sustained outcomes, including significant improvements in pain scores, reduced narcotic consumption, and enhanced QoL over a 12-month follow-up period.
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This study aims to facilitate the translation of innovative closed-loop deep brain stimulation (DBS) strategies from theory to practice by establishing a research platform. The platform addresses the challenges of real-time stimulation artifact removal, low-latency feedback stimulation, and rapid translation from animal to clinical experiments. ⋯ This work provides a research tool for rapidly deploying innovative closed-loop strategies for translational research in both animal and clinical studies. The platform's capabilities in real-time data processing and low-latency control represent a significant advancement in translational DBS research, with potential implications for the development of more effective therapeutic interventions.