Neuromodulation : journal of the International Neuromodulation Society
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Failed back surgery syndrome (FBSS) patients experience pain, functional disability, and reduced health-related quality of life (HRQoL) despite anatomically successful surgery. Examining sub-dimensions of health outcomes measures provides insight into patient well-being. ⋯ Longer-term patient management and research must focus on these refractory FBSS patients with persisting poor function and HRQoL outcomes.
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In the present investigation, we applied the whole-hand transcutaneous electrical nerve stimulation (TENS) therapy to two incomplete tetraplegic subjects and assessed their progress with four evaluation methods. ⋯ From the comparison of four evaluation methods, it is evident that different assessments and measurements should be used in order to get better picture of patient's upper extremity impairment.
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Deep brain stimulation applied to the periaqueductal grey matter (PAG) of the midbrain in humans has been shown to increase or decrease arterial blood pressure during rest and to resist the postural fall on standing. The mechanism by which this effect is elicited is unknown. We hypothesize that PAG stimulation modulates performance of the autonomic nervous system. ⋯ PAG stimulation modulates autonomic nervous system activity and thereby elicits changes in cardiovascular performance. Understanding of the mechanisms by which this therapy causes cardiovascular modulation will inform future innovation in this field with the aim of improving the efficacy and safety of patient treatment options.
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We evaluated trends in deep brain stimulation (DBS) for the 14-year period from 1993 to 2006. ⋯ Future studies will need to include the socioeconomic impact of the technology on disease status, patient access, and costs as it expands to novel indications.
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This study aimed to assess the long-term results of deep brain stimulation (DBS) for patients affected with Gilles de la Tourette syndrome, documenting refractoriness to conservative treatments. ⋯ Gilles de la Tourette syndrome is a complex neuropsychiatric disorder with a significant prevalence in the general population. More than 50% of the patients with TS present a behavioral comorbidity, and anxiety and depression are, to various degrees, associated to this "waxing and waning" clinical picture. DBS in our experience proved to be a valid treatment modality for those patients who fail to respond to conservative treatment modalities. A multidisciplinary team is nevertheless necessary to properly handle this complex therapeutic option.