Neuromodulation : journal of the International Neuromodulation Society
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Randomized Controlled Trial
A feasibility study to investigate the effect of functional electrical stimulation and physiotherapy exercise on the quality of gait of people with multiple sclerosis.
To examine the effect of Functional Electrical Stimulation (FES) for dropped foot and hip instability in combination with physiotherapy core stability exercises. ⋯ The intervention was feasible. FES for dropped foot may improve mobility and quality of life and may reduce falls. Adding gluteal stimulation further improved gait quality. Adding physiotherapy may have enhanced the effect of FES, but FES had the dominant effect.
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The study shows placement of spinal cord stimulators using an Epiducer for placement of multiple cylindrical leads or single S-8 paddle leads. It also gives tips for problem-solving Epiducer use. ⋯ Some problems with Epiducer placement may occur. But these problem-solving techniques may help in troubleshooting.
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Randomized Controlled Trial
Neuromodulation of emotion using functional electrical stimulation applied to facial muscles.
Major depressive disorder (MDD) is a common condition for which available pharmaceutical treatments are not always effective and can have side-effects. Therefore, alternative and/or complementary MDD treatments are needed. Research on facial expressions has shown that facial movements can induce the corresponding emotions, particularly when specific attention is paid to voluntarily activating muscles that are typically only activated involuntarily while expressing emotions. We hypothesized that functional electrical stimulation (FES) applied to facial muscles may enhance this effect due to its ability to modulate central nervous system plasticity. Thus, applying FES to the facial muscles associated with smiling (including the "Duchenne marker") may increase the activity of subcortical nuclei related to positive emotions and counteract symptoms of depression. ⋯ These results suggest that modulating emotion using FES may be possible, but is difficult to target accurately. Further work is warranted to explore FES applications to MDD.
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Data regarding rehospitalization and emergency department (ED) visits following vagus nerve stimulation (VNS) present data analysis challenges. We present a method that uses California's multiple databases to more completely assay VNS efficacy. ⋯ VNS surgery has low rates of complications and reoperations and is associated with reduced incidence of seizure-related ED visits and hospital admissions in the first and second postoperative years.
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Postoperative programming in deep brain stimulation (DBS) therapy for movement disorders can be challenging and time consuming. Providing the neurologist with tools to visualize the electrode location relative to the patient's anatomy along with models of tissue activation and statistical data can therefore be very helpful. In this study, we evaluate the consistency between neurologists in interpreting and using such information provided by our DBS programming assistance software. ⋯ Our five neurologists demonstrated high consistency in interpreting information provided by the CRAVE interactive visualization software for DBS postoperative programming assistance. Three of our five neurologists had no prior experience with the software, which suggests that the software has a short learning curve and contact selection is not dependent on familiarity with the program tools.