Neuromodulation : journal of the International Neuromodulation Society
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Deep brain stimulation (DBS) is an established neuromodulatory technique for treating drug-resistant epilepsy. Despite its widespread use in carefully selected patients, the mechanisms underlying the antiseizure effects of DBS remain unclear. Herein, we provide a detailed overview of the current literature pertaining to experimental DBS in rodent models of epilepsy and identify relevant trends in this field. ⋯ Rodent models have significantly advanced the understanding of disease pathophysiology and the development of novel therapies. However, fundamental questions remain regarding DBS mechanisms, optimal targets, and parameters. Further research is necessary to improve DBS therapy and tailor treatment to individual patient circumstances.
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The human soleus muscles are essential for maintaining cardiac output during upright posture, but age and disuse lead to soleus atrophy, causing numerous health complications in older adults. Here, we investigate the influence of plantar nerve stimulation on soleus muscle activity focusing on ways exogenous stimulation technology can be optimized for the rejuvenation of the soleus muscles. ⋯ MMG analysis provides a sensitive and quantitatively reproducible assessment that has confirmed the ability of plantar nerve modulation to enhance soleus muscle performance in both the short and long term. Because soleus atrophy in older adults leads to numerous detrimental health conditions in these adults, the ability to rejuvenate the soleus muscles through simple, noninvasive, nerve modulation therapy supports use of this strategy as an effective clinical intervention. Results obtained here also indicate that MMG can play an important role in optimizing nerve modulation strategies in this application area.
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Initial deep brain stimulation (DBS) programming using a monopolar review is time-consuming, subjective, and burdensome. Incorporating neurophysiology has the potential to expedite, objectify, and automatize initial DBS programming. We aimed to assess the feasibility and performance of clinically implemented sensing-based initial DBS programming for Parkinson's disease (PD). ⋯ This study shows that sensing-based initial DBS programming for PD is feasible and rapid, and selected clinically effective contacts in most patients, including those with tremor. Technologic innovations and practical developments could improve sensing-based programming.
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Review Meta Analysis
Systematic Review and Meta-analysis of Stimulation of the Medial Branch of the Lumbar Dorsal Rami for the Treatment of Chronic Low Back Pain.
Chronic low back pain (CLBP) is often associated with impaired motor control and degeneration of the lumbar multifidus muscles. Several studies have reported on the utility of multifidus or medial branch stimulation as a treatment. We present a systematic review and meta-analysis of studies reporting on the change in low back pain intensity with multifidus stimulation. ⋯ Medial branch stimulation for the treatment of CLBP shows a high probability of a clinically significant change in pain intensity. Longer duration of stimulation was associated with decreased low back pain intensities.
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This prospective, open-label, single-arm, multicenter study evaluated the use of differential target multiplexed (DTM) spinal cord stimulation (SCS) therapy for chronic upper limb pain (ULP). ⋯ In this patient population with difficult-to-treat conditions with limited clinical evidence of the effectiveness of SCS, subjects reported significant reduction in chronic ULP in response to treatment with DTM SCS.