Neuromodulation : journal of the International Neuromodulation Society
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We reviewed the clinical applications, academic communications, and specialized training required for deep brain stimulation (DBS) in China. Current problems and possible solutions also were discussed. ⋯ DBS has evolved significantly during the past decade in China. There are still several problems. The advent of Chinese homemade DBS hardware, multidisciplinary cooperation, and the establishment of guidelines and regulations for DBS will improve the application of this surgical treatment in China.
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Review
Gastric neuromodulation with Enterra system for nausea and vomiting in patients with gastroparesis.
Gastric electrical stimulation (GES) has been introduced for treating gastric motility disorders, such as gastroparesis, and obesity. A special method of GES using high frequency-short pulses, called Enterra® Therapy, has been clinically applied to treat nausea and vomiting in patients with gastroparesis. However, its mechanisms are not well understood. ⋯ GES with high frequency-short pulses effectively reduces nausea and vomiting in patients with gastroparesis. This antiemetic effect could be mediated via enteric, autonomic, and/or central neural mechanisms. Further systematic and controlled studies are needed to improve the efficacy of Enterra Therapy and to understand its mechanisms of action.
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Long-term studies of subthalamic nucleus (STN) deep brain stimulation (DBS) in patients with Parkinson's disease have shown potential cognitive and linguistic side-effects. In this pilot study, we examined whether direct monopolar stimulation in the ventral, associative STN would result in language effects. ⋯ Our data support previous findings implicating STN stimulation in cognitive-linguistic effects. A larger patient group with a blinded methodology is warranted.
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Deep brain stimulation (DBS) is an effective modality of treating cardinal motor symptoms of several movement disorders such as Parkinson's disease, essential tremor, and dystonia. Although hardware-related complications of DBS have been reported, the cosmetic satisfaction and discomfort associated with infraclavicular subcutaneous implantation of the pulse generator has not been described. The authors adopted a technique of transaxillary subpectoral implantable pulse generator (IPG) placement and investigated the difference in the discomfort, cosmetic satisfaction, mean operation time for IPG implantation, and severity of postoperative pain between infraclavicular subcutaneous placement and transaxillary subpectoral implantation of IPG. ⋯ These results demonstrated that subpectoral transaxillary IPG implantation can provide better cosmetic satisfaction in patients undergoing DBS, with less discomfort and morbidity related to erosion and infection.
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To compare larger diameter corkscrew-tined leads with previously described intracardiac pacing leads for temporary gastric neurostimulation in a canine model. ⋯ These results suggest that the current concept of temporary gastric electrical neurostimulation via a mucosal approach must be reevaluated, as the procedure most likely does not accurately mimic electrical stimulation in the muscularis.