Neuromodulation最新文献

{"title":"Randomized Clinical Trials on Neurostimulation for Chronic Pain: Do They Comply With the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) Criteria?","authors":"Ryan S D'Souza, Eliana Ege, Michael Zhitnitsky, Larry Prokop, Nasir Hussain","doi":"10.1016/j.neurom.2025.09.307","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.09.307","url":null,"abstract":"<p><strong>Background: </strong>Variability in outcome reporting among randomized clinical trials (RCTs) evaluating neurostimulation for chronic pain may hinder evidence synthesis and patient-centered care. This study aimed to assess the extent to which RCTs of implantable neurostimulation interventions adhere to the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) recommendations, which define six core outcome domains for chronic pain research.</p><p><strong>Materials and methods: </strong>We conducted a systematic review of 63 RCTs evaluating spinal cord stimulation, dorsal root ganglion stimulation, and peripheral nerve stimulation for chronic pain. We extracted data on whether each of the six IMMPACT-recommended outcome domains-pain intensity, physical functioning, emotional functioning, participant ratings of global improvement or satisfaction, adverse events, and participant disposition-was reported. We also recorded study design, funding source, journal impact factor, device type, and year of publication. A linear regression model assessed associations between IMMPACT adherence and select study characteristics.</p><p><strong>Results: </strong>All 63 RCTs (100%) reported pain intensity. Reporting of other IMMPACT domains varied: physical functioning (66.7%, n = 42), emotional functioning (57.1%, n = 36), and global impression or satisfaction (66.7%, n = 42). Only 11.1% (n = 7) of studies explicitly referenced the IMMPACT framework, and among these, only three (42.8%) reported all six core domains. Cross-over-designed RCTs reported significantly fewer IMMPACT domains than parallel-group RCTs (β = -1.11, 95% CI -1.76 to -0.47; p = 0.001). No significant associations were found between IMMPACT adherence and journal impact factor, funding source, device type, or publication year.</p><p><strong>Conclusions: </strong>These findings highlight ongoing inconsistencies in multidimensional outcome reporting within neuromodulation research. Greater adherence to standardized frameworks such as IMMPACT recommendations is needed to better capture the full spectrum of patient-relevant outcomes, improve trial comparability and external validity, and support broader evidence synthesis. Integration of IMMPACT alongside Consolidated Standards of Reporting Trials may strengthen the quality and relevance of neuromodulation RCTs and promote comprehensive assessments of treatment success.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308727","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":"Effects of Transcutaneous Auricular Vagus Nerve Stimulation in Individuals with Primary Dysmenorrhea: A Randomized Controlled Trial.","authors":"Zeynep Yıldız Kızkın, Rıdvan Yıldız, Ali Veysel Özden","doi":"10.1016/j.neurom.2025.09.306","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.09.306","url":null,"abstract":"<p><strong>Background and aims: </strong>Transcutaneous auricular vagus nerve stimulation (taVNS) is a promising neuromodulation therapy with proved efficacy in treating various conditions, such as migraine, depression, abdominal pain, constipation, stroke, and sleep disorders. However, no randomized controlled trials have evaluated the effects of taVNS in patients with primary dysmenorrhea (PwPD). This study aims to investigate the impact of taVNS on pain, functional and emotional symptoms, and physical performance in PwPD.</p><p><strong>Materials and methods: </strong>In this study, conducted over two menstrual cycles, 34 PwPD were randomly assigned (1:1) to the taVNS or Sham groups. The treatment protocol comprised taVNS or sham treatment for five consecutive days, starting five days before the expected second menstrual period. The Numerical Rating Scale (NRS), pressure pain threshold (PPT), the Menstrual Symptom Questionnaire (MSQ), the Functional and Emotional Measure of Dysmenorrhea (FEMD), the Hamilton Anxiety Scale (HAM-A), and the 6-Minute Walking Test (6MWT) were evaluated at the first and subsequent menstrual cycles.</p><p><strong>Results: </strong>The difference between the groups was significant, favoring the taVNS group in the NRS, PPT, MSQ, FEMD, HAM-A, and 6MWT (for all, p < 0.05). Time, treatment, and time × treatment interaction were found to have significant effects on all treatment parameters except 6MWT (for all, p < 0.05).</p><p><strong>Conclusion: </strong>PwPD may benefit from taVNS, given it has shown efficacy in alleviating pain and menstrual symptoms while improving physical performance.</p><p><strong>Clinical trial registration: </strong>The Clinicaltrials.gov registration number for the study is NCT06146569.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313226","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":"Use of High-Frequency 10-kHz Spinal Cord Stimulation in the Treatment of Persistent Spinal Pain Syndrome Type 2: A Systematic Review.","authors":"Saiganesh Ravikumar, Brandon Stevens, Te'Amrat Mehreteab, Michael Erdek","doi":"10.1016/j.neurom.2025.08.417","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.08.417","url":null,"abstract":"<p><strong>Objectives: </strong>In 2015, 10-kHz high-frequency (10-kHz) spinal cord stimulation (SCS) received Food and Drug Administration approval to treat persistent spinal pain syndrome type 2 (PSPS-2). The outcomes of 10-kHz SCS on PSPS-2 have not been systematically reviewed. We systematically reviewed the relevant literature and hypothesized that 10-kHz SCS is safe and effective in managing pain in patients with PSPS-2.</p><p><strong>Materials and methods: </strong>PUBMED and EMBASE data bases were searched with the query ((spinal cord stimulator) OR (spinal cord stimulation) OR (SCS)) AND (pain) AND ((10 khz) OR (10-khz) OR (HF10) OR (HF-10)) on April 24, 2024.</p><p><strong>Results: </strong>The search produced 636 nonduplicate articles. After applying the inclusion/exclusion criteria, nine studies were selected. Seven studies reported the percentage passing 10-kHz SCS trial, and the weighted average based on the number of patients was 87.3% success rate overall. Three studies measured overall pain on the visual analog scale (VAS), and six measured VAS back and leg separately. The weighted average for VAS overall, back, and leg was 8.1 (preoperation), 4.7 (postoperation); 7.0 (preoperation), 2.0 (postoperation); and 5.7 (preoperation), 1.6 (postoperation), respectively. Two studies evaluated the Beck Depression Index, and the weighted average was 23.8 (preoperation) and 14.0 (postoperation). Three studies evaluated the Oswestry Disability Index (ODI), and the weighted average was 48.3 (preoperation) and 30.6 (postoperation). Two studies compared burst stimulation with 10-kHz SCS, and both found no difference in back pain scores, whereas both studies found greater improvement in leg pain in the burst groups. Two studies compared low-frequency SCS with 10-kHz SCS, and both studies found no significant difference in VAS or ODI scores between the two treatments. There were no reported unanticipated adverse device effects across the studies.</p><p><strong>Conclusion: </strong>For many patients with refractory PSPS-2, 10-kHz SCS is a safe, effective treatment, but there is a lack of evidence of its superiority to burst or traditional SCS.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313241","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":"Quantitative Evaluation of Tonic Spinal Cord Stimulation in Treating Chemotherapy-Induced Peripheral Neuropathy: A Single-Center Prospective Cohort Exploratory Pilot Study.","authors":"Serena Jiyeon Kim, Patrick M Dougherty, Salahadin Abdi, Saba Javed","doi":"10.1016/j.neurom.2025.09.305","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.09.305","url":null,"abstract":"<p><strong>Objectives: </strong>Chemotherapy-induced peripheral neuropathy (CIPN), a prevalent and debilitating side effect of neurotoxic agents, affects a significant proportion of patients with cancer during and after treatment. Spinal cord stimulation (SCS) has shown limited efficacy in relieving the symptoms of chronic neuropathic pain. In this prospective, single-center pilot study, nine patients with lower-extremity CIPN underwent tonic SCS implantation.</p><p><strong>Materials and methods: </strong>Treatment-Induced Neuropathy Assessment Scale (TNAS) scores, Patient-Reported Outcomes Measurement Information System (PROMIS)-29 + 2 Profile v2.1 (PROPr) patient-reported outcomes (PROs), gait assessments, and quantitative sensory tests (QSTs) were administered at baseline and at 30 days, 90 days, six months, and 12 months after SCS. Statistical analyses included repeated measures analysis of variance or paired t-tests for normally distributed data, Friedman and Wilcoxon signed-rank tests for nonparametric data, and Pearson correlations among TNAS domains, QST measures, and gait velocity.</p><p><strong>Results: </strong>At 30 days after SCS, patients indicated significant improvements across all TNAS domains and PROMIS-29 outcomes of pain interference, physical functioning, and pain intensity (all p < 0.01). Gait analysis revealed improved velocity (p = 0.002) and ambulation time (p = 0.014). QSTs showed significantly decreased (improved) touch thresholds and sharp thresholds at 30 days at subtalus (all p < 0.05). Greater CIPN symptom severity, as measured by TNAS numbness, tingling, pain, and walking difficulty scores, was significantly associated with slower gait velocity (ρ = -0.60 to -0.52, all p < 0.001). In addition, higher touch- and sharp-detection thresholds were strongly correlated with higher TNAS scores (all p < 0.01).</p><p><strong>Conclusions: </strong>Our preliminary findings highlight the potential therapeutic effects of SCS on alleviating CIPN-related pain and neuropathy and support the use of psychophysical testing to monitor disease progression and/or improvement after intervention. However, future studies with larger and more diverse patient populations are needed to validate the use of SCS and gait analysis in clinical practice.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308688","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":"Oxygen-15 Labeled Water Positron Emission Tomography During External Trigeminal Nerve Stimulation.","authors":"Christopher M DeGiorgio, Lara M Schrader, Patrick Miller, Mary K Susselman, Cheri L Geist, Ian A Cook, Daniel Silverman","doi":"10.1016/j.neurom.2025.06.017","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.06.017","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Neuromodulation through external trigeminal nerve stimulation (eTNS) is an emerging noninvasive wearable treatment for neuropsychiatric disorders including attention deficit disorder, epilepsy, and major depression. eTNS is now US Food and Drug Administration approved for attention deficit disorder and investigational for the treatment of epilepsy, major depression, and other neuropsychiatric disorders. Rodent studies indicate eTNS activates key brainstem nuclei, in addition to the amygdala and hippocampus. However, the effect of eTNS on cortical blood flow and metabolism is not known. A better understanding of which brain areas are activated or deactivated by eTNS would provide a scientific basis for current applications and could provide a roadmap to identify new disease targets and interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aimed to investigate the effect of eTNS on brain blood flow using oxygen-15 labeled water positron emission tomography ([&lt;sup&gt;15&lt;/sup&gt;O]H&lt;sub&gt;2&lt;/sub&gt;O PET) to advance the understanding of the networks, pathways, and mechanisms of action of eTNS in humans.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;Institutional review board approval and informed consent were obtained. Five subjects underwent eTNS using electrodes positioned 2.5 cm from the nasal midline to stimulate the paired supraorbital branches of the trigeminal nerve. [&lt;sup&gt;15&lt;/sup&gt;O]H&lt;sub&gt;2&lt;/sub&gt;O brain PET scans were performed using a Siemens-CTI HR+ EXACT system at the University of California Los Angeles Laboratory of Neuroimaging. Three scans were performed with trigeminal stimulation ON (scans 1, 3, and 6), and three scans were performed with trigeminal stimulation OFF (scans 2, 4, and 5). Data were analyzed comparing stimulus ON with stimulus OFF scans. Adjustments for multiple comparisons were performed using the family-wise error correction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;eTNS of the supraorbital branches of the trigeminal nerve produced significant activations (increased cerebral blood flow) in bilateral anterior cingulate gyri; bilateral parieto-temporal cortex; left inferior frontal gyrus; and right medial and middle frontal gyri. The most significant deactivations (decreased blood flow) occurred in the left parahippocampal gyrus, right sensorimotor cortex, right superior parietal area, bilateral temporo-occipital cortex, and bilateral visual cortex.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;eTNS of bilateral supraorbital nerves (V&lt;sub&gt;1&lt;/sub&gt; division) generates significant activations during [&lt;sup&gt;15&lt;/sup&gt;O]H&lt;sub&gt;2&lt;/sub&gt;O PET imaging in regions associated with major depression and attention deficit disorder. Deactivations of cortical regions including the parahippocampal gyrus, sensorimotor cortex, and others provide a rationale for some of the antiseizure effects of trigeminal nerve stimulation. The results of this study advance our understanding of mechanisms of action of trigeminal nerve stimulation in neu","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313235","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":"Evoked Resonant Neural Activity Reveals an Electrophysiologic Sweet Spot for Directional Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease.","authors":"Tine Van Bogaert, Jana Peeters, Alexandra Boogers, Wim Vandenberghe, Philippe De Vloo, Bart Nuttin, Myles Mc Laughlin","doi":"10.1016/j.neurom.2025.09.303","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.09.303","url":null,"abstract":"<p><strong>Objectives: </strong>Deep brain stimulation (DBS) targeting the subthalamic nucleus (STN) is a well-established treatment for Parkinson's disease (PD), yet programming remains empirical and time-consuming. Evoked resonant neural activity (ERNA), a stimulation-evoked oscillatory response recorded from the STN, has shown promise as a biomarker for optimizing DBS therapy. This study aimed to evaluate the utility of ERNA as a physiologically grounded biomarker for optimizing STN DBS by 1) characterizing its sensitivity to stimulation parameters and directional contact location, 2) identifying its spatial distribution using directional leads, and 3) assessing correspondence between the ERNA-defined sweet spot and established clinical targets.</p><p><strong>Materials and methods: </strong>We recorded ERNA intraoperatively from 14 patients with PD who underwent awake STN-DBS implantation with directional leads. ERNA features were analyzed across stimulation amplitudes and contacts. A sweet spot was derived based on the anatomical location of stimulation settings associated with high ERNA magnitudes. Spatial correspondence with previously published clinical sweet spots was evaluated.</p><p><strong>Results: </strong>ERNA magnitude scaled with stimulation intensity and varied across directional contacts, showing consistent directional tuning across depths. Sweet spot analysis localized high-amplitude ERNA responses to a focal dorsal STN cluster at the motor-associative border. This ERNA-defined sweet spot closely aligned (centroid distance: 1.41-2.08 mm) with four independent clinical targets.</p><p><strong>Conclusions: </strong>ERNA is a spatially specific and physiologically meaningful signal that aligns with clinically effective stimulation sites. Its sensitivity to directional stimulation highlights its high spatial resolution, supporting its use as an objective biomarker to guide DBS programming. Future studies should explore its utility in long-term therapeutic settings.</p><p><strong>Clinical trial registration: </strong>The Clinicaltrials.gov registration number for the study is NCT04658641.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302541","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":"A Review of Mechanistic Effects of Low-Intensity Focused Ultrasound.","authors":"Pravarakhya Puppalla, Ugur Kilic, Derek D George, AnneLeigh Twer, Minza Haque, Lotanna Ojukwu, Julie G Pilitsis","doi":"10.1016/j.neurom.2025.07.006","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.07.006","url":null,"abstract":"<p><strong>Background/objectives: </strong>Low-intensity focused ultrasound (LIFU) has become increasingly used in neuromodulation. However, its mechanisms of action are less well understood. Here, we provide a scoping review of the effects of LIFU on nervous system tissue.</p><p><strong>Materials and methods: </strong>We evaluated the PubMed, SCOPUS, and Web of Science data bases for articles using the keywords related to LIFU and neuromodulation; 3970 articles were retrieved and titles screened by two authors (AT and MH) with conflicts resolved by one author (PP). The abstract review included 837 articles, and full-text review included 371 articles; 157 articles were included in the final manuscript.</p><p><strong>Results: </strong>The mechanisms of action of LIFU for neuromodulation have been studied in vitro, in preclinical models, and in humans. LIFU exerts both excitatory and inhibitory modulatory effects through ion channel activation, changes in neurotransmission, and certain gene expression pathways. These changes cause localized and distributed effects in brain tissue and in behavioral modification in human trials and nonhuman models, depending on stimulation parameters and region targeted. Most LIFU research focuses on cerebral neuromodulation whereas some data exist for spinal cord and peripheral nerve neuromodulation.</p><p><strong>Conclusion: </strong>Considerable growth in research evaluating LIFU's ability to modulate the nervous system has occurred. Although safety and efficacy have been indicated, heterogeneity in LIFU operating parameters may cause nuanced differential effects on target tissue. By further elucidating the mechanisms of LIFU neuromodulation, future research will advance treatments for chronic neurologic diseases.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302484","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":"Upper Extremity Muscle Recovery Profiles With Functional Electrical Stimulation Therapy in Chronic Spinal Cord Injury.","authors":"Gustavo Balbinot, Guijin Li, Alexandra Chen, Parvin Eftekhar, Wenky Ma, Sukhvinder Kalsi-Ryan, José Zariffa","doi":"10.1016/j.neurom.2025.08.416","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.08.416","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injuries (SCIs) often cause significant functional impairments. Functional electrical stimulation therapy (FEST) aims to enhance muscle strength, particularly when natural recovery decreases. However, the recovery profiles of individual muscles treated with FEST during the chronic phase are not well understood. The primary objective of this study was to characterize the timing and magnitude of gains in individual muscle strength during FEST. The secondary objective was to identify factors predictive of the response.</p><p><strong>Materials and methods: </strong>This cohort study evaluated the strength recovery profiles of 136 muscles treated with FEST, from 17 participants with chronic cervical SCI. Electrophysiology was conducted at baseline to assess corticospinal tract (CST) integrity and the excitability of the lower motor neuron pools using surface electromyography.</p><p><strong>Results: </strong>Overall, 69 muscles did not respond to the treatment whereas 67 muscles showed a median strength increase of one muscle motor score (MMS). Among responder muscles, achieving a one-MMS increase required approximately 59 days (19.2 FEST sessions). A prediction model highlighted key predictors of responsiveness to FEST, including baseline MMS, characteristics of lesion location/severity, and neurophysiologic indicators of CST integrity.</p><p><strong>Conclusions: </strong>Our findings can inform rehabilitation medicine guidelines for FEST in cervical SCI. The data indicate that achieving a one-point increase in muscle strength requires approximately 59 days and 19 FEST sessions. CST integrity and the responsiveness of lower motor neuron pools may influence FEST outcomes. These insights will enable more personalized and effective rehabilitation strategies, optimizing outcomes and resource allocation for individuals living with cervical SCI.</p><p><strong>Clinical trial registration: </strong>The Clinicaltrials.gov registration number for the study is NCT05462925.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302559","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":"Ultrasound Applications in the Treatment of Major Depressive Disorder: A Systematic Review of Techniques and Therapeutic Potentials in Clinical Trials and Animal Model Studies.","authors":"Gansheng Tan, Hong Chen, Eric C Leuthardt","doi":"10.1016/j.neurom.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.08.001","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Major depressive disorder (MDD) is a debilitating condition that inflicts significant personal and economic burdens and affects approximately 8% of the US population. Approximately 30% of patients with MDD do not respond to conventional antidepressant and psychotherapeutic treatments. Current treatment options for refractory MDD include transcranial magnetic stimulation (TMS) and invasive surgical procedures such as surgical ablation, vagus nerve stimulation, and deep brain stimulation. In this context, therapeutic ultrasound emerges as a promising alternative for treating refractory MDD, which has the unique advantage of combining noninvasiveness with selective targeting. Over the past ten years, there has been growth in focused ultrasound research, leading to an exponential increase in interest in the technology. To support the future development of ultrasound for treating MDD, we conducted a systematic review following Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;We identified 86 relevant studies from 1975 through June 2025. Our inclusion criteria were peer-reviewed prospective cohort studies, case-control studies, and randomized controlled trials that report ultrasound efficacy for treating depression in humans or depressive-like behaviors in animal models (International Prospective Register of Systematic Reviews registration number: CRD42024626093); 23 studies met all the inclusion criteria. We summarized ultrasonic techniques for treating depression and their efficacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified two focused ultrasound techniques used to treat depression, including magnetic resonance-guided focused ultrasound (MRgFUS) for capsulotomy and low-intensity focused ultrasound (LIFUS) neuromodulation. MRgFUS capsulotomy causes permanent lesioning, whereas LIFUS is nonlesional and believed to have temporary effects. In human trials, the response rate (≥50% improvement in depression score from baseline) was 41.7% at 12 months postoperatively for MRgFUS capsulotomy and 56.3% for LIFUS neuromodulation, respectively. The odds ratio for LIFUS neuromodulation was 5.8. In addition, LIFUS neuromodulation had a large effect (|Cohen's d| &gt; 0.8) on reducing standard depression scale scores in humans or resolving depressive-like behaviors in rodents. The certainty of evidence is moderate for human trials and low for rodent models. MRgFUS capsulotomy had inconsistent lesioning success and a limited response rate, whereas LIFUS neuromodulation lacked systematic exploration of the parameter space and clear delineation of the underlying mechanisms. Future work should refine patient selection for MRgFUS capsulotomy and optimize the parameters for individualized functional targeting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;LIFUS neuromodulation achieved a large reduction in depressive behaviors in both rodent models and human trials. We conclud","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308663","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":"Both Transcutaneous Auricular Vagus Nerve Stimulation and Great Auricular Nerve Stimulation Modulate Functional and Structural Connectivity of Brainstem Nuclei in Chronic Low Back Pain.","authors":"Yuanyuan Li, Tingting Li, Keming Yan, Jiani Wu, Sveta Reddy, Valeria Sacca, Amy Katherine Ursitti, Meixuan Zhu, Sierra Hodges, Lucy Chen, Jian Kong","doi":"10.1016/j.neurom.2025.08.415","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.08.415","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the modulatory effects of transcutaneous auricular vagus nerve stimulation (taVNS) and transcutaneous greater auricular nerve stimulation (tGANS) on the brainstem's vagus nerve pathway hubs-the nucleus tractus solitarius (NTS), locus coeruleus (LC), and raphe nucleus (RN)-in individuals with chronic low back pain (cLBP).</p><p><strong>Materials and methods: </strong>A total of 70 patients with cLBP were randomly assigned to receive four weeks of either taVNS or tGANS. Resting-state functional and structural magnetic resonance imaging (fMRI/sMRI) data were collected at baseline and post treatment. Analyses focused on static and dynamic functional connectivity (sFC/dFC) and fractional anisotropy (FA) using the NTS, LC, and RN--three brainstem nuclei within the central vagus nerve pathway-as seed regions.</p><p><strong>Results: </strong>Overall, 51 participants completed the treatment. Both groups showed significant pain improvement, with no significant difference between the taVNS and tGANS groups. taVNS was found to influence connectivity between the NTS and cingulate cortex, sensorimotor areas, thalamus, insula, operculum, and prefrontal cortex; between the LC and primary motor area and amygdala; and between the RN and sensory and prefrontal regions. In contrast, tGANS affected connectivity between the NTS and temporoparietal junction; between the LC and prefrontal cortex; and between the RN and insula and hippocampus. Changes in FA further supported the sFC findings. Notably, in the taVNS group, an increase in FA was negatively correlated with a decrease in sFC between the LC and precentral cortex.</p><p><strong>Conclusions: </strong>Both taVNS and tGANS can modulate functional and structural connectivity between brainstem nuclei of the central vagus nerve pathway and multiple cortical/subcortical regions, albeit through different neural circuits.</p><p><strong>Clinical trial registration: </strong>The Clinicaltrials.gov registration number for the study is NCT03959111.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293199","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}