Neuromodulation最新文献

{"title":"Optimization Simulations of Transcranial Direct Current Stimulation Montages in Children With Perinatal Stroke.","authors":"Martin Bardhi, Ephrem Takele Zewdie, Adam Kirton, Helen L Carlson","doi":"10.1016/j.neurom.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.05.002","url":null,"abstract":"<p><strong>Background: </strong>Perinatal stroke (PS) is a vascular brain injury that causes most hemiparetic cerebral palsy. Transcranial direct current stimulation (tDCS) applies a weak electric field (EF) to the scalp, and targeting motor cortex (M1) paired with therapy may improve motor function. However, owing to developmental differences and idiosyncratic anatomy after early injury, optimal electrode placements are not known. We optimized electrode placements on the basis of individual anatomy and explored the resulting EF propagation patterns.</p><p><strong>Objective/hypothesis: </strong>We hypothesized that children with PS would have greater electrode displacement distances from standard montages and that optimizations could improve the strength and direction of EF at M1 targets.</p><p><strong>Materials and methods: </strong>Magnetic resonance images of participants with PS and of controls were preprocessed, segmented, and converted to three-dimensional meshes. SimNIBS (Thielscher, Copenhagen, Denmark) modeled EF for various tDCS electrode placements. Optimal placements were modeled to maximize EF strength or direction at the targeted M1. Electrode displacement distances and directions in addition to EF metrics were compared in groups and optimization strategies.</p><p><strong>Results: </strong>Optimal electrode displacement distance was greater in the arterial ischemic stroke group when EF strength in the lesioned M1 was optimized (W = 4.31, p < 0.01), located further posterior than controls. The opposite trend was observed when current direction was optimized (W = 3.68, p = 0.025). Displacement direction had higher variability in children with PS across all optimizations. Montage optimization improved EF metrics. Specifically, the anodal nondirectionally optimized protocol caused greater EF strength in simulations of participants with PS. Directionally optimized montages altered average current angle through the target M1, making it closer to perpendicular to the posterior bank of the precentral gyrus in all groups.</p><p><strong>Conclusions: </strong>Individualized electrode placements may optimize tDCS current propagation in children with PS, with tradeoffs between current direction and EF strength. tDCS current optimization may improve noninvasive neuromodulation therapies in children with disabilities.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptive vs Conventional Deep Brain Stimulation of the Subthalamic Nucleus for Treatment of Parkinson's Disease: A Multicenter Retrospective Study.","authors":"Qinghua Li, Kailiang Wang, Jiping Li, Penghu Wei, Yongzhi Shan, Jianyu Li, Junming Zhu, Zhe Zheng, Chaoshi Niu, Chi Xiong, Weiguo Li, Qianqian Wu, Qihua Xiao, Guiyun Cui, Xiongfei Wang, Yuguang Guan, Guoming Luan, Baohui Liu, Huimin Dong, Siquan Liang, Haitao Li, Wenwen Xu, Guoguang Zhao, Yuqing Zhang","doi":"10.1016/j.neurom.2025.04.011","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.04.011","url":null,"abstract":"<p><strong>Objectives: </strong>Conventional deep brain stimulation (cDBS) is an established treatment for Parkinson's disease (PD), whereas adaptive DBS (aDBS) represents a promising approach with potential advantages in minimizing stimulation-induced side effects and enhancing quality of life. This study evaluated the safety and efficacy of a newly developed aDBS closed-loop neurostimulation (CNS) device for one year across multiple centers, with the primary objective of comparing the outcomes of aDBS and cDBS.</p><p><strong>Materials and methods: </strong>This retrospective study included 62 patients with PD who underwent bilateral subthalamic nucleus (STN) DBS. Outcomes were assessed using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Parkinson's Disease Questionnaire-39 (PDQ-39), and Schwab and England Activities Scale, whereas the levodopa-equivalent daily dose (LEDD) and adverse events were monitored. This two-phase trial randomized participants into Stim-on or Stim-off groups for 90-day postoperative comparison followed by nonrandomized evaluation of aDBS vs cDBS at 360 days after surgery.</p><p><strong>Results: </strong>At 90 days postoperatively, the Stim-on group exhibited superior outcomes to those in the Stim-off group except for LEDD and speech in the medication-on state. At the 360-day postoperative assessment, the aDBS group showed significantly greater improvements than did the cDBS group in MDS-UPDRS II (57.29% vs 33.02%, p = 0.022), MDS-UPDRS IV (59.83% vs 36.69%, p = 0.026), PDQ-39 (56.91% vs 27.37%, p = 0.031), and LEDD reduction (53.35% vs 29.16%, p = 0.002). CNS aDBS recorded clear STN-beta signals, which could be adopted as a biomarker.</p><p><strong>Conclusions: </strong>Both aDBS and cDBS significantly alleviate motor symptoms and enhance quality of life in patients with PD. Although comparable in motor symptom control, aDBS indicated advantages over cDBS across LEDD reduction, MDS-UPDRS II, MDS-UPDRS IV, and PDQ-39 over the long term. Further studies with extended follow-up and larger sample sizes are required to validate these results.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jeffrey Ardell, PhD (December 20, 1952-February 12, 2025).","authors":"Robert D Foreman, Siamak Salavatian","doi":"10.1016/j.neurom.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.04.009","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Spinal Cord Stimulation on Patients' Ability to Work and Work-Related Outcomes.","authors":"Furkan Gazozcu, Alessa Schütz, Ralph T Schär, Janine-Ai Schlaeppi","doi":"10.1016/j.neurom.2025.03.079","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.03.079","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic low back pain is one of the most common causes of absence from work. This not only has economic consequences but also affects the mental health of patients. Furthermore, returning to work is one of the main concerns of patients with chronic pain. Spinal cord stimulation (SCS) has shown its effectiveness in pain reduction and quality of life in many studies. Work-related outcomes have often been neglected or only marginally documented.</p><p><strong>Objective: </strong>The aim of this study is to examine specific work-related data of the patients before and after surgery and to assess the influence of SCS on the ability to work with a review of the literature.</p><p><strong>Materials and methods: </strong>This is a single-center retrospective study with prospective data collection. All patients were operated on by the same surgeon at the University Hospital Bern between October 2018 and October 2022. Data were collected during postoperative follow-up and by telephone call. In addition, a literature search was conducted to identify previous research on this topic.</p><p><strong>Results: </strong>Of the 26 patients included in this study, 18 were on disability leave before SCS whereas eight were still working. After SCS, five of the 18 patients on disability leave were able to return to work within a mean period of 58.3 weeks with a standard deviation of 33.59 after surgery, with a workload of ≥20%. Two of these patients transitioned to a new profession. This corresponds to a return-to-work (RTW) rate of 27.8% for patients previously unemployed in our study. Among the eight patients who were employed before SCS, all were able to resume work. Those who had been working full-time (n = 4) maintained their full workload, whereas the four patients who had previously reduced their workload were able to sustain or even slightly increase their employment percentage.</p><p><strong>Conclusion: </strong>Our study shows a positive impact of SCS on the patients' work ability with an RTW rate of 27.8%. The findings not only indicate a favorable influence on patients' health and well-being but also create positive economic implications.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preclinical Insights Into the Effects of Frequency and Pulse Width on Evoked Compound Action Potential Morphology During Spinal Cord Stimulation.","authors":"Kimberley Ladner, Eline M Versantvoort, Dave Mugan, Quoc C Vuong, Birte E Dietz, Annie Hu, Marjolein E G Thijssen, Robert B Gorman, Erika Petersen, Ilona Obara","doi":"10.1016/j.neurom.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.05.001","url":null,"abstract":"<p><strong>Objectives: </strong>High-frequency spinal cord stimulation (SCS) at 1000 Hz was shown to reduce evoked compound action potential (ECAP) amplitude, likely owing to asynchronous firing of dorsal column (DC) axons. To investigate the relationship between SCS parameters and DC axon activation, we analyzed ECAP morphology across different stimulation frequencies and pulse widths (PWs).</p><p><strong>Materials and methods: </strong>Adult male Sprague-Dawley rats (200-400 g) were implanted with an epidural lead. To study SCS frequency effects, baseline recordings were taken at 2 Hz, followed by tests at 50, 200, 500, and 1000 Hz, with 2 Hz recovery periods; 200 Hz also was applied in a pig with an epidurally implanted lead. PW effects were assessed in rats by increasing the PW from 50 to 1000 μs, in 50 μs increments per minute.</p><p><strong>Results: </strong>In contrast to 50 Hz, SCS at 200, 500, and 1000 Hz reduced ECAP amplitude and increased peak latencies and ECAP width. Conduction velocity (CV) was reduced at 500 and 1000 Hz. Recovery intervals at 2 Hz, after 200, 500, and 1000 Hz, showed a gradual return to baseline values for ECAP morphology parameters. Similar effects occurred in the pig. Increasing PW prolonged peak latencies, with ECAP amplitudes decreasing from 200 to 250 μs.</p><p><strong>Conclusions: </strong>DC axon responses to SCS at increasing frequencies or PWs depend on their recovery state, as reflected in changes to ECAP morphology and CV. These effects may result from desynchronization, demyelination, or differences within fiber recruitment. Further investigation into these mechanisms can improve the efficacy of SCS therapy.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"33. Multidimensional outcomes of spinal cord simulation in patients with chronic pain: results from a European prospective multicenter observational study","authors":"S. Thomson ,&nbsp;N. Varela ,&nbsp;V. Mehta ,&nbsp;J. Calle ,&nbsp;J. Vesper ,&nbsp;S. Love-Jones ,&nbsp;J. De Andres ,&nbsp;S. Bayerl ,&nbsp;B. Bujedo ,&nbsp;G. Baranidharan ,&nbsp;A. Mendiola ,&nbsp;C. Perez ,&nbsp;L. Demartini ,&nbsp;J.W. Kallewaard ,&nbsp;K. Gatzinsky ,&nbsp;G. Matis ,&nbsp;E. Goldberg","doi":"10.1016/j.neurom.2025.03.035","DOIUrl":"10.1016/j.neurom.2025.03.035","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Page S17"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"22. Economic evaluations comparing deep brain stimulation to best medical therapy for movement disorders: a meta-analysis","authors":"M. Lannon ,&nbsp;T. Duda ,&nbsp;A. Mastrolonardo ,&nbsp;E. Huang ,&nbsp;A. Martyniuk ,&nbsp;F. Farrokhyar ,&nbsp;F. Xie ,&nbsp;M. Bhandari ,&nbsp;S.K. Kalia ,&nbsp;S. Sharma","doi":"10.1016/j.neurom.2025.03.024","DOIUrl":"10.1016/j.neurom.2025.03.024","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Page S12"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"35. Non-invasive modulation of spinal nerve root activity","authors":"C. Keogh,&nbsp;J.J. FitzGerald","doi":"10.1016/j.neurom.2025.03.037","DOIUrl":"10.1016/j.neurom.2025.03.037","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Page S18"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"29. Initial experience with deep brain stimulation in a patient in minimally conscious state","authors":"K. Waterhouse,&nbsp;A.M. Vitali,&nbsp;L. Gould,&nbsp;J. Norton,&nbsp;S. McLeod","doi":"10.1016/j.neurom.2025.03.031","DOIUrl":"10.1016/j.neurom.2025.03.031","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Page S15"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"51. Restorative multifidus neurostimulation: a retrospective analysis of outcomes at 1 year at York hospital","authors":"H. Soar,&nbsp;P. Armstrong,&nbsp;P. Hall,&nbsp;A. Britten,&nbsp;H. Lambert,&nbsp;S. Atkin","doi":"10.1016/j.neurom.2025.03.053","DOIUrl":"10.1016/j.neurom.2025.03.053","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Page S26"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}