Neuromodulation : journal of the International Neuromodulation Society
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The effect of spinal cord stimulation (SCS) on cerebral blood flow (CBF) has, in the past, been evaluated by semiquantitative techniques, but has not been used to treat CBF diseases. The aim of this study was to assess the effect of cervical SCS on regional blood flow by both semiquantitative and quantitative methods. Thirty-five patients with cervical SCS-implanted devices were enrolled. ⋯ During cervical SCS there was a significant and bilateral increase in systolic (21%) and diastolic (26%) velocity in the MCA and in CCA blood flow (50%). We conclude that cervical SCS increases blood flow in the middle cerebral artery and common carotid artery. The consistent increase supports the potential usefulness of cervical SCS as an adjuvant treatment for cerebral blood flow diseases.
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The aim of this study was to investigate the causation of an insufficient clinical response to acute external stimulation after implantation of brain stimulating electrodes in patients with idiopathic Parkinson's disease (IPD). This study represents to our knowledge the first consecutive postoperative monitoring of the electrical properties of electrodes and tissue in this patient cohort. We hypothesized that changes in brain tissue resistance would be etiologic for this clinically observed phenomenon. ⋯ The changes of the voltage drop on the electrodes and the tissue were insignificant over the time course. We conclude that the decline of the clinical benefit is not due to an alteration of tissue resistivity. As an explanation, we postulate that the reactive formation/resolution of edema around the electrode has the same resistivity as the target and is therefore not detectable by our measurements or modulated by a still unknown mechanism.
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The paper describes an original method of endoluminal electrical stimulation of the stomach developed by authors. The aim of the study was to compare two types of electrical stimulation: low frequency (LF) and high frequency (HF) in human patients. Twenty-three patients with postoperative gastroparesis (after abdominal surgery) were involved in the study and randomized into two groups. ⋯ Symptoms score decreased on the consecutive days of pacing from 8.3 to 3.8, 1.3, to 0.9 in the LF group and from 8.2 to 3.1, 1.0, to 0 in the HF group. We conclude that HF is more effective than LF in the treatment of postoperative gastroparetic human patients. No adverse effects of HF and LF were observed in this study.
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Objective. The outcomes of different modes of TENS (transcutaneous electrical nerve stimulation) in relieving experimental heat and cold pain were studied. Materials and methods. Three modes of stimulation, conventional, burst, and high rate frequency modulation (HRFM) including placebo, were trancutaneously applied to 20 right handed healthy volunteers (10 males and 10 females). Stimulation was carried out using two pad electrodes placed over the median nerve for 120 s in each case. ⋯ Conclusions. All modes of stimulation statistically decreased both heat and cold pain when compared to placebo. HRFM was the most effective mode of TENS. It might be worthwhile to test the patterns of stimulation in chronic pain patients.
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The performance of cathode-anode configurations in a cuff electrode to stimulate a single fascicle in a nerve trunk has been investigated theoretically. A three-dimensional volume conductor model of a nerve trunk with four fascicles in a cuff electrode and a model of myelinated nerve fiber stimulation were used to calculate the recruitment of 15 m fibers in each fascicle. The effect of a monopole, a transverse bipole (anode opposite the cathode), and a narrow transverse tripole (guarded cathode) in selectively stimulating 15 m fibers in each fascicle has been quantified and presented as recruitment curves. ⋯ As compared to monopolar and longitudinal tripolar stimulation, the slope of the recruitment curves in transverse bipolar stimulation is reduced considerably, thus allowing improved fine tuning of nerve (and thus force) recruitment. Another advantage of this method is a minimal number of cable connections to the cuff electrode. The cost of the improved selectivity is an increased stimulation current.