Brain Stimul
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Why are weak sensory stimuli sometimes perceived and other times not? Experimental paradigms using near-threshold stimuli suggest that spontaneous brain network dynamics are involved in separating relevant from irrelevant information. Recent findings in human visual perception provide evidence that the immediate spontaneous brain state, i.e. the phase of alpha oscillations, predicts whether a coinciding stimulus is further processed or not. ⋯ Our data indicate that tACS applied at an endogenous frequency is capable of modulating human somatosensory perception by inducing phase-dependent periods of excitation and inhibition, i.e. entraining ongoing mu-alpha oscillations. These findings support the idea that the "pulsed inhibition" framework for sensory gating applies to somatosensory mu-alpha oscillations and might therefore represent a general, but sensory-specific mechanism of conscious human perception.
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Review Meta Analysis
Is Motor Cortical Excitability Altered in People with Chronic Pain? A Systematic Review and Meta-Analysis.
Chronic pain is characterised by maladaptive neuroplasticity in many systems, including the motor system. There is evidence that patients with chronic pain demonstrate altered corticospinal and intracortical excitability; however, findings are inconsistent and existing literature in this area has not been systematically reviewed. ⋯ There is evidence of motor cortex disinhibition in chronic pain populations, suggestive of a disruption in GABA-mediated intracortical inhibition. Disinhibition was more pronounced in populations with neuropathic pain. These findings provide new insights into the relationship between chronic pain and motor cortex excitability, which may have meaningful implications for the future treatment of chronic pain conditions.
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Randomized Controlled Trial
Randomized Single Blind Sham Controlled Trial of Adjunctive Home-Based tDCS after rTMS for Mal De Debarquement Syndrome: Safety, Efficacy, and Participant Satisfaction Assessment.
Mal de debarquement syndrome is a medically refractory disorder characterized by chronic rocking dizziness that occurs after exposure to passive motion. Repetitive transcranial magnetic stimulation (rTMS) can acutely suppress the rocking dizziness but treatment options that extend the benefit of rTMS are needed. ⋯ Home-based tDCS can be performed safely and may be beneficial in selected individuals. Adequate teaching, automatic device safety features, and a good communications infrastructure are components of successful home therapy.
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Randomized Controlled Trial Multicenter Study
Transcutaneous Vagus Nerve Stimulation (tVNS) for Treatment of Drug-Resistant Epilepsy: A Randomized, Double-Blind Clinical Trial (cMPsE02).
Various brain stimulation techniques are in use to treat epilepsy. These methods usually require surgical implantation procedures. Transcutaneous vagus nerve stimulation (tVNS) is a non-invasive technique to stimulate the left auricular branch of the vagus nerve at the ear conch. ⋯ tVNS had a high treatment adherence and was well tolerated. Superiority of 25 Hz tVNS over 1 Hz tVNS could not be proven in this relatively small study, which might be attributed to the higher stimulation intensity in the control group. Efficacy data revealed results that justify further trials with larger patient numbers and longer observation periods.
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Vagus nerve stimulation (VNS) paired with forelimb training drives robust, specific reorganization of movement representations in the motor cortex. The mechanisms that underlie VNS-dependent enhancement of map plasticity are largely unknown. The cholinergic nucleus basalis (NB) is a critical substrate in cortical plasticity, and several studies suggest that VNS activates cholinergic circuitry. ⋯ Together, these findings indicate that the NB is required for VNS-dependent enhancement of plasticity in the motor cortex and may provide insight into the mechanisms that underlie the benefits of VNS therapy.