Brain Stimul
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Randomized Controlled Trial
Variability in response to transcranial direct current stimulation of the motor cortex.
Responses to a number of different plasticity-inducing brain stimulation protocols are highly variable. However there is little data available on the variability of response to transcranial direct current stimulation (TDCS). ⋯ The large variability in response to these TDCS protocols is in line with similar studies using other forms of non-invasive brain stimulation. The effects highlight the need to develop more robust protocols, and understand the individual factors that determine responsiveness.
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Transcranial direct current stimulation (tDCS) is known to reliably alter motor cortical excitability in a polarity dependent fashion such that anodal stimulation increases cortical excitability and cathodal stimulation inhibits cortical excitability. However, the effect of tDCS on agonist and antagonist volitional muscle activation is currently not known. ⋯ Our results indicate that anodal tDCS significantly affects the voluntary EMG/force relationship of the agonist muscles without altering the coactivation of the antagonistic muscles. The most likely explanation for the observed greater EMG per unit force after anodal tDCS appears to be related to alterations in motor unit recruitment strategies.
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Deep brain stimulation has become a routine therapy for movement disorders, but it is relatively invasive and costly. Although stimulation intensity relates to battery longevity, less is known about how diagnosis and stimulation target contribute to this clinical outcome. Here we evaluate battery longevity in movement disorders patients who were treated at a tertiary referral center. ⋯ Pallidal DBS for dystonia was associated with shorter battery longevity and more frequent stimulator adjustments versus DBS for Parkinson's disease and essential tremor. Characteristics of the stimulation target and disease pathophysiology both likely contribute to battery longevity in patients with movement disorders.
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Epilepsy is a common neurological disease affecting over 40 million people worldwide. The foremost important challenge of epileptologists has been to control and predict the recurrent and spontaneous seizures of epileptic patients. The application of low frequency electrical stimulation (LFS) in deep brain structures has shown promising results in seizure control. However, the use of LFS as a probing strategy for seizure prediction, thus contributing to a closed loop solution, is still poorly explored. ⋯ ES induces a detectable temporal rearrangement of pre-ictal activity, which has suggestive applicability to seizure prediction.
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Randomized Controlled Trial
Effects of a non-focal plasticity protocol on apathy in moderate Alzheimer's disease: a randomized, double-blind, sham-controlled trial.
Apathy is the most common neuropsychiatric symptom in Alzheimer's disease (AD) and it is associated with changes in prefrontal neural circuits involved with generation of voluntary actions. To date no effective treatment for apathy has been demonstrated. ⋯ In this adequately powered study for minimal clinically significant difference, our findings show that using the parameters we chose for this study, repeated anodal tDCS over the left DLPFC had no effect on apathy in elderly patients with moderate AD.