Neuromodulation最新文献

{"title":"Repetitive Transcranial Magnetic Stimulation for Refractory and Super-refractory Status Epilepticus: A Systematic Review.","authors":"Chloé Algoet, Kato Van Rooy, Paul Boon, Evelien Carrette, Sofie Carrette, Mathieu Sprengers, Robrecht Raedt, Ann Mertens, Alfred Meurs, Kristl Vonck","doi":"10.1016/j.neurom.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.02.001","url":null,"abstract":"<p><strong>Rationale: </strong>Off-label treatments are often considered to treat refractory status epilepticus (RSE) and superrefractory status epilepticus (SRSE). To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) as a treatment for (S)RSE, we performed a systematic review.</p><p><strong>Materials and methods: </strong>Cessation of (S)RSE after rTMS was extracted as the primary end point from manuscripts describing patients with (S)RSE treated with rTMS. Data relevant to epilepsy history, (S)RSE type and etiology, prior treatment for (S)RSE, prior duration of (S)RSE, rTMS parameters, number of treatment sessions, duration of rTMS protocols, latency to (S)RSE cessation, recurrence rate, adverse events, and long-term outcome were collected as secondary end points.</p><p><strong>Results: </strong>We identified 33 patients; 17 of 33 had epilepsia partialis continua; 7 of 33 had new onset RSE. Data were incomplete in 3 of 33 regarding classification and etiology; 18 of 30 had focal motor status epilepticus (SE), 9 of 30 nonconvulsive SE, and 3 of 30 convulsive SE. The most frequent etiologies were cortical malformation (8/31), stroke (5/31), and genetic mutations (5/31). Median duration of (S)RSE before rTMS was 70 days (range: two-7300, interquartile range = 148, Q1 = 32, Q3 = 180). In 25 of 33 patients (75.8%), rTMS caused cessation of (S)RSE after zero to four days. (S)RSE recurred in eight of 17 patients (47%), for whom follow-up was available. Three deaths occurred from the underlying disease.</p><p><strong>Conclusion: </strong>rTMS caused cessation in 75.8% of patients with (S)RSE within four days, with recurrence in 47%. To determine the therapeutic potential of rTMS for patients with (S)RSE, further studies are required given the present findings stem from level IV studies and may have reporting bias.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730932","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":"Fluoroscopy-Guided Percutaneous Placement of Peripheral Nerve Stimulator of the Cervical Medial Branches in Patients With Treatment-Refractory Occipital Neuralgia: A Case Series.","authors":"Qing Zhao Ruan, Adriano Bellotti, Amitabh Gulati, Lisa Gfrerer, Daniel Pak, David Reece, Sean Li, Jun Beom Ku, Christopher L Robinson, Rohan Jotwani","doi":"10.1016/j.neurom.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.02.004","url":null,"abstract":"<p><strong>Background: </strong>Pain from occipital neuralgia (ON) stems from the compression of the greater occipital nerve, muscle hypertrophy, or spasm. C2-C3 facet joint pain also is implicated in ON, given the third occipital nerve's innervation of the C2-C3 zygapophysial joint. Percutaneous peripheral nerve stimulation (PNS) has in recent years been popularized as a minimally invasive approach in the management of treatment-resistant ON.</p><p><strong>Objective: </strong>The study seeks to summarize the various modalities used in percutaneous peripheral nerve stimulator placement for ON in the existing literature and propose a novel fluoroscopic technique for effective peripheral nerve stimulator implantation established through a retrospective institutional case series for treatment of patients with ON.</p><p><strong>Materials and methods: </strong>MEDLINE was accessed for our literature search, and the time frame of the search was set from data base inception to May 1, 2024. Our institutional retrospective chart review was performed in patients who had undergone new implantation of the SPRINT PNS system (SPR Therapeutics, Inc, Cleveland, OH) from January 2023 to May 2024. Parameters extracted from patients' charts for analysis included patient demographics, pain presentation, prior treatments and injection-based interventions, pain intensity, and opioid medications used.</p><p><strong>Results: </strong>A total of five articles meeting the inclusion criteria were obtained after screening a total of 74 studies, describing peripheral nerve stimulator placement techniques using ultrasound, fluoroscopy, and a combination of both. Five institutional subjects were assessed in our case series. During active PNS therapy, there was a clinically significant reduction in pain (≥50%) intensity as measured by visual analog scale (VAS) score in all five subjects (N = 5, mean 7.20 vs 1.68, 95% CI [-8.87, -2.17], p = 0.0102). At 60 days, pain relief improved (N = 5, mean 7.20 vs 1.32, 95% CI [-8.97, -2.78], p = 0.0062). After device removal, the VAS score trended lower without attaining significance (n = 4, mean 7.5 vs 3.13, 95% CI [-11.04, 2.29], p = 0.128).</p><p><strong>Conclusions: </strong>Our fluoroscopic-guided peripheral nerve stimulator placement technique yielded pain relief from therapeutic commencement to up to 18 weeks from device placement, exhibiting an efficacy equivalent to that of existing modalities of lead placement published in literature.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692836","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":"Accelerated Transcutaneous Auricular Vagus Nerve Stimulation for Inpatient Depression and Anxiety: The iWAVE Open Label Pilot Trial.","authors":"Christopher W Austelle, Stewart S Cox, Dillon J Connolly, Brenna Baker Vogel, Xiaolong Peng, Kristin Wills, Falon Sutton, Katherine B Tucker, Ethan Ashley, Andrew Manett, Bernadette Cortese, Edward Baron Short, Bashar W Badran","doi":"10.1016/j.neurom.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.02.003","url":null,"abstract":"<p><strong>Introduction: </strong>Brain stimulation is not a common inpatient psychiatric treatment; however, there are an increasing number of neuromodulation treatments approved for psychiatric indications. Noninvasive techniques, such as transcutaneous auricular vagus nerve stimulation (taVNS), are promising and should be investigated in this novel setting. This study evaluates the safety and feasibility of taVNS on the inpatient psychiatric unit and preliminarily explores efficacy for comorbid depression and anxiety.</p><p><strong>Materials and methods: </strong>Ten adult patients (five women, mean age ± SD, 35.60 ± 19.14 years) admitted to the inpatient psychiatric unit with comorbid depression and anxiety participated in this open-label safety and feasibility trial. Patients were randomized to receive one of two taVNS dosing approaches: 1) three taVNS sessions on three consecutive days (nine sessions total) (n = 5) or 2) nine taVNS sessions in one day (n = 5). Each day, we assessed depression, using the Patient Health Questionnaire (PHQ-9) and Beck Depression Inventory (BDI), and anxiety, using the Generalized Anxiety Disorder-7 (GAD-7) and Beck Anxiety Inventory (BAI).</p><p><strong>Results: </strong>Both taVNS dosing approaches were safe and feasible in this novel setting. There were no serious adverse events, and we observed a low rate of minor adverse effects, which was similar across treatment conditions. Regardless of condition, stimulation significantly reduced GAD-7 (mean reduction ± SD, -5.90 to 6.87, p < 0.05), BAI (-9.40 ± 10.52, p < 0.05), PHQ-9 (-6.00 ± 7.57, p < 0.05), and BDI (-11.00 ± 11.59, p < 0.05) final scores compared with baseline. There was not a significant difference in clinical response between treatment conditions.</p><p><strong>Discussion: </strong>In this open label study, taVNS significantly decreased depression and anxiety symptoms in patients admitted to the inpatient unit. The small sample size in this trial limited our ability to characterize patient characteristics that may drive response. However, our results suggest taVNS may be an effective adjunct to inpatient psychiatric treatment and should continue to be studied in this setting.</p><p><strong>Clinical trial registration: </strong>The Clinicaltrials.gov registration number for the study is NCT05791383.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674401","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":"Noninvasive Vagus Nerve Stimulation in Parkinson's Disease: A Systematic Review.","authors":"Negin Eissazade, Shayan Eghdami, Mohammad Rohani, Atra Ajdari, Seyed-Mohammad Fereshtehnejad, Alfonso Fasano, Tara Khoeini","doi":"10.1016/j.neurom.2025.01.012","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.01.012","url":null,"abstract":"<p><strong>Background: </strong>While pharmacologic interventions remain the mainstay of Parkinson's disease (PD) treatment, alternative approaches such as vagus nerve stimulation (VNS) have drawn attention for their potential in managing PD symptoms.</p><p><strong>Objective: </strong>We aimed to conduct a systematic review to comprehensively evaluate the safety and efficacy of VNS for motor and nonmotor symptoms of PD.</p><p><strong>Materials and methods: </strong>A systematic search was conducted across PubMed, Scopus, Cochrane Library, and Web of Science for relevant journal articles published up to October 2024. The findings were descriptively reported to evaluate the overall safety and efficacy of VNS in addressing both motor and nonmotor features of PD.</p><p><strong>Results: </strong>A total of 12 journal articles with data from 287 participants were included. Ten studies reported that VNS significantly improved gait characteristics. Category fluency significantly declined in one study. Additionally, nonsignificant changes were observed in gastroenteric symptoms, fatigue, and both sympathetic and parasympathetic cardiac activity, with each of these outcomes reported in a separate study.</p><p><strong>Conclusions: </strong>Noninvasive VNS demonstrated favorable safety and efficacy for gait impairments in patients with PD, indicating its potential as a versatile intervention capable of addressing multiple aspects of the disease pathology. However, further research is necessary to reveal the underlying mechanisms, optimize stimulation parameters, and assess the long-term safety and efficacy of VNS as a therapeutic strategy for PD.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586419","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":"Assessing the Efficacy of Spinal Cord Stimulation in Managing Painful Diabetic Neuropathy: A Systematic Review and Meta-Analysis.","authors":"Abdallah Abbas, Moaz Abouelmagd, Mohamed El-Moslemani, Ahmed Diaa, Ahmed Samir, Mohamed Hatem Ellabban, Ali Bakr, Amira M Taha, Mahmoud Tarek Hefnawy, Mostafa Hossam El Din Moawad, Dina Essam Abo-Elnour, Amna Hussein, Hoda Awad, Alaa Rashad, Ahmed Negida, Ahmed M Raslan","doi":"10.1016/j.neurom.2025.01.016","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.01.016","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus affects more than half a billion people globally, often leading to painful diabetic neuropathy (PDN). Spinal cord stimulation (SCS) has emerged as a promising treatment for PDN.</p><p><strong>Objective: </strong>This meta-analysis evaluated the efficacy of SCS compared with the best medical therapy (BMT) for PDN.</p><p><strong>Materials and methods: </strong>Following the Preferred Reporting Items of Systematic reviews and Meta-Analyses guidelines, a systematic search of the PubMed, Scopus, Web of Science, Embase, and Cochrane CENTRAL data bases was conducted up to December 1, 2023 and updated on January 2, 2025. Data extraction was performed using Microsoft Excel, and quality assessment was conducted using Cochrane's Risk of Bias 2.0 and ROBINS-1 tools. Statistical analysis and heterogeneity assessment were performed using Review Manager (RevMan) software (The Cochrane Collaboration, London, UK).</p><p><strong>Results: </strong>Nine clinical trials involving 407 patients were included. The analysis revealed significant pain reduction in the SCS group (mean difference [MD]: -5.46, 95% CI: [-6.09, -4.83], p < 0.00001). Subgroup analysis indicated pain relief benefits in both conventional SCS (MD: -4.176, 95% CI: [-4.865, -3.486], p < 0.001) and 10-kHz SCS (MD: -4.581, 95% CI: [-6.376, -2.785], p < 0.001). SCS also achieved higher treatment success rates (≥50% pain relief) than did BMT (risk difference: 0.59, 95% CI: [0.33, 0.85], p < 0.00001). Moreover, SCS significantly improved the EuroQol-5 Dimension utility index (MD: 0.16, 95% CI: [0.10, 0.23], p < 0.00001) and self-reported health (MD: 15.29, 95% CI: [4.51, 26.07], p = 0.005).</p><p><strong>Conclusion: </strong>This meta-analysis provides robust evidence supporting SCS as an effective intervention for managing chronic pain and enhancing the quality of life in patients with PDN, highlighting its superiority to conventional medical therapy.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586417","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 First-In-Human Feasibility Study of a New Implantable Tibial Nerve Stimulator for Overactive Bladder Syndrome.","authors":"Parminder S Sethi, Kenneth M Peters","doi":"10.1016/j.neurom.2025.01.013","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.01.013","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the preliminary feasibility and safety of a new implantable tibial nerve stimulator device in patients with overactive bladder (OAB).</p><p><strong>Materials and methods: </strong>Ten patients with OAB in whom conservative treatments had failed participated in the study. All patients received daily stimulation therapy for two weeks and weekly stimulation therapy for 13 weeks, at the lowest electrical output amplitude at which paresthesia or motor response occurred. OAB symptoms (three-day bladder diary), quality-of-life scores (OAB-questionnaire Short Form), and patient global response (GRA) were assessed at each follow-up visit.</p><p><strong>Results: </strong>Among the patients enrolled (mean age 68 years), seven were OAB-wet and three OAB-dry. After 13 weeks of therapy delivery, a reduction in the number of daily voids during waking hours (8.5 ± 2.5 to 6.3 ± 1.9; p = 0.016), incontinence episodes (2.5 ± 1.8 to 0.3 ± 0.5; p < 0.001), and the daily voids associated with urgency (7.6 ± 3.1 to 3.0 ± 3.1; p < 0.001) was reported. Eight of the ten subjects were classified as responders for ≥one OAB component, with one patient reporting worsened symptoms of urgency (+6%). All ten patients reported global improvement in symptoms on the GRA with a median score of 6. Improvements in OAB severity and health-related quality-of-life scores were noted from pre- to posttreatment across participants (p < 0.001). No serious adverse effects were noted.</p><p><strong>Conclusion: </strong>This first-in-human pilot study allowed for capture of preliminary safety and effectiveness information on a new implantable tibial nerve stimulator device in the population of interest to adequately power a larger, pivotal randomized study.</p><p><strong>Clinical trial registration: </strong>The Clinicaltrials.gov registration number for the study is NCT04115228.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542557","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":"Safety and Effectiveness of Multisite Transcutaneous Spinal Cord Stimulation Combined With Activity-Based Therapy When Delivered in a Community Rehabilitation Setting: A Real-World Pilot Study.","authors":"Jenny Suggitt, Jane Symonds, Jessica M D'Amico","doi":"10.1016/j.neurom.2025.01.005","DOIUrl":"10.1016/j.neurom.2025.01.005","url":null,"abstract":"<p><strong>Objective: </strong>The primary aim of this study was to preliminarily evaluate the safety and efficacy of multisite transcutaneous spinal cord stimulation (tSCS) combined with activity-based therapy (ABT) in individuals with chronic spinal cord injury (SCI) when delivered in a community-based neurorehabilitation center.</p><p><strong>Materials and methods: </strong>Ten participants were enrolled in a nonrandomized pilot trial. Participants completed 120 sessions of tSCS + ABT focused on recovery of upper extremity, trunk, and lower extremity function dependent on their neurologic level of injury. NeuroRecovery Scale (NRS), Berg Balance Scale (BBS), pinch and grasp force, and Graded and Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP) were obtained at baseline and every 20 sessions. International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), quality of life, spasticity, and respiratory measures were assessed at baseline and after 40 and 120 sessions. Nonparametric testing with post hoc correction was used to assess improvements in outcomes.</p><p><strong>Results: </strong>Median improvements (median [interquartile range]) in NRS-total (Δ1.5 [1.0, 2.0]), NRS-trunk (Δ2.0 [1.2, 3.1]), and BBS scores (Δ2.0 [0, 4.5]) were significant after 120 sessions of tSCS-ABT (all p < 0.013). In the cervical cohort, median improvements in NRS-upper extremity (Δ2.1 [0.6, 2.5]), GRASSP-Sensibility (Δ1.0 [0.0, 1.5]), Prehension ability (Δ2.0 [1.0, 5.5]), and Prehension performance (Δ10.0 [7.5, 13.5]) were significant (all p < 0.05). Post hoc comparisons revealed continued improvements with an increased number of sessions. There were no significant improvements in the ISNCSCI motor and sensory scores as a group; however, three individuals showed improved American Spinal Injury Association Impairment Scale classifications, with four individuals also indicating changes in the neurologic level of injury. No improvements were noted in other exploratory outcomes.</p><p><strong>Conclusions: </strong>Combined tSCS + ABT facilitated functional recovery after chronic SCI. Improvements required ≥60 tSCS-ABT sessions, with further exposure to tSCS facilitating continued improvement. These findings indicate that prolonged training with tSCS-ABT can be an effective neuromodulatory intervention for individuals with SCI.</p><p><strong>Clinical trial registration: </strong>The Clinicaltrials.gov registration number for the study is NCT04132596.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493066","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":"Response to: YouTube as a Source of Medical Information About Peripheral Nerve Stimulation.","authors":"Levent Karataş","doi":"10.1016/j.neurom.2025.01.014","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.01.014","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493062","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 Auricular Stimulation on Inflammatory Parameters: Results of a Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Kevin Hua, Mike Cummings, Miriam Bernatik, Benno Brinkhaus, Taras Usichenko, Stefan N Willich, Carmen Scheibenbogen, Joanna Dietzel","doi":"10.1016/j.neurom.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.neurom.2024.12.007","url":null,"abstract":"<p><strong>Background: </strong>The number of randomized controlled trials (RCTs) using auricular stimulation (AS) techniques, such as transauricular vagus nerve stimulation, auricular electrostimulation, auricular acupuncture, and acupressure in experimental and clinical settings has increased markedly over the last three decades. This systematic review evaluates the effects of AS on biomarkers of inflammation and stress responses.</p><p><strong>Materials and methods: </strong>The following data bases were searched: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science, and Scopus Data base. Data collection and analysis were conducted independently by two reviewers. Quality and risk assessments of the included studies were performed, and a meta-analysis of the effects of the most frequently assessed biomarkers was conducted using RevMan statistical software.</p><p><strong>Results: </strong>A total of 1122 patients and healthy volunteers from 27 RCTs were included in this systematic review; 81% of the participants were female, with a median age of 51 years. Pooled data of 18 studies showed a significant effect of AS regarding a reduction of serum C-reactive protein, tumor necrosis factor-α, interleukin (IL)-6, and IL-10. Although IL-4, IL1β, cortisol, substance P and calcitonin gene-related peptide, and adrenocorticotropic hormone did not show any changes, salivary amylase increased under AS.</p><p><strong>Conclusions: </strong>The influence of inflammatory cytokines seems to be mediated by AS. More research is needed to investigate the effects of AS on the immunologic system in addition to its clinical significance in high-quality RCT.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493047","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":"Phase-Amplitude Coupling in Response to Transcutaneous Vagus Nerve Stimulation: Focus on Regions Implicated in Mood and Memory.","authors":"Charlotte Keatch, Elisabeth Lambert, Will Woods, Tatiana Kameneva","doi":"10.1016/j.neurom.2025.01.011","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.01.011","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate whether transcutaneous vagus nerve stimulation (tVNS) at different frequencies affects phase-amplitude coupling among regions of the brain linked to mood and memory disorders using simultaneous magnetoencephalography (MEG) in healthy participants.</p><p><strong>Materials and methods: </strong>Phase-amplitude coupling was measured among brain areas in response to different stimulation frequencies of tVNS using concurrent MEG and tVNS in 17 healthy participants. The 4 protocols were: 24 Hz cymba concha, 1 Hz cymba concha, PFM cymba concha, and 24 Hz ear lobe. A driven autoregressive method was used to estimate the coupling among brain areas in different physiological frequency bands in response to these protocols.</p><p><strong>Results: </strong>Different tVNS stimulation protocols led to alterations in phase-amplitude coupling among multiple brain regions linked to mood and memory, notably the prefrontal cortex, hippocampus, and temporal pole. Stimulation delivered at 24 Hz was observed to decrease delta-gamma coupling within the temporal pole and cingulate cortex when contrasted with 24-Hz sham stimulation. Increased alpha-gamma coupling was observed between the hippocampus and prefrontal cortex when contrasting 24 Hz with pulse-frequency-modulated stimulation. Finally, a comparison of 24-Hz with low-frequency 1-Hz stimulation showed an increase in theta-gamma coupling within the prefrontal cortex.</p><p><strong>Significance: </strong>To our knowledge, this study represents the first attempt to quantify phase-amplitude coupling in response to tVNS and suggests that different stimulation frequencies can modulate coupling between different areas of the brain. Abnormal phase-amplitude coupling has been linked to multiple mood and memory disorders. Further investigations using different stimulation frequencies of tVNS to alter phase-amplitude coupling may lead to the development of tVNS as a therapeutic option for different medical conditions.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493059","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}