Neuromodulation最新文献

{"title":"Effect of Deep Brain Stimulation on Comorbid Self-injurious Behavior: A Systematic Review and Meta-analysis of Individual Patient Data","authors":"Karim Mithani MD, MEng ,&nbsp;Kristina Zhang BMSc ,&nbsp;Han Yan MD ,&nbsp;Lior Elkaim MD ,&nbsp;Peter J. Gariscsak BSc ,&nbsp;Hrishikesh Suresh MD ,&nbsp;Flavia Venetucci Gouveia PhD ,&nbsp;Alfonso Fasano MD, PhD ,&nbsp;Carolina Gorodetsky MD ,&nbsp;George M. Ibrahim MD, PhD","doi":"10.1016/j.neurom.2024.07.009","DOIUrl":"10.1016/j.neurom.2024.07.009","url":null,"abstract":"<div><h3>Objective</h3><div>Self-injurious behavior (SIB) can occur in the setting of many neurologic disorders that are amenable to deep brain stimulation (DBS). Although certain brain targets are believed to be particularly effective for SIB, improvements in the primary neurologic condition may also reduce co-occurring SIB. We performed a systematic review and meta-analysis of individual participant data to characterize the effects of DBS across various neurologic disorders and brain targets on comorbid SIB.</div></div><div><h3>Materials and Methods</h3><div>A systematic review of all available literature on DBS in treating disorders with co-occurring SIB was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Individual participant data were extracted and standardized mean differences (SMDs) in metrics of SIB severity and/or frequency were calculated for meta-analysis. Demographic variables and adverse events were also collated.</div></div><div><h3>Results</h3><div>Data from 59 patients, identified from 24 articles, with comorbid SIB who underwent DBS for various indications were extracted. The primary neurologic diagnoses included Tourette syndrome (<em>n</em> = 40), dystonia (<em>n</em> = 7), epilepsy (<em>n</em> = 5), acquired brain injury (<em>n</em> = 3), dyskinesia (<em>n</em> = 2), and obsessive-compulsive disorder (<em>n</em> = 2). Overall, DBS was highly effective in treating comorbid SIB (Mean SMD = −2.4, <em>p</em> &lt; 0.0001) across primary disorders and intracranial targets. Patients with dystonia and DBS targeting the posterior hypothalamus had relatively less success at mitigating comorbid SIB.</div></div><div><h3>Conclusions</h3><div>In patients with comorbid SIB, DBS to treat the primary neurologic condition may also mitigate SIB. Although several targets are emerging for the treatment of severe SIB, this work suggests that DBS targeting the primary neurologic condition should be first considered in comorbid SIB.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 3","pages":"Pages 373-379"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292172","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: The Neurostimulation Appropriateness Consensus Committee (NACC) ©: Recommendations for the Mitigation of Complications of Neurostimulation","authors":"Nick J. Koning MD, PhD ,&nbsp;Jan Willem Kallewaard MD, PhD","doi":"10.1016/j.neurom.2025.01.001","DOIUrl":"10.1016/j.neurom.2025.01.001","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 3","pages":"Pages 545-546"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747761","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":"Health Economic Evaluation and Patient Perspectives on a Virtual Clinic: Advancing Digital Remote Care in Health Care.","authors":"Pedram Tabatabaei, Josef Salomonsson, Linda Bredemo, Johan Wänman","doi":"10.1016/j.neurom.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.02.007","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing adoption of digital health care solutions offers a transformative opportunity to improve patient access while addressing sustainability and cost-efficiency challenges. Our study evaluates a virtual remote care system (VRCS) that has been implemented at our clinic in northern Sweden. By combining patient-centered outcomes, environmental metrics, and health economic models, this study examines the impact of a VRCS on patient satisfaction, resource utilization, and environmental sustainability.</p><p><strong>Materials and methods: </strong>Eighty patients with chronic pain, treated with spinal cord or dorsal root ganglion stimulation, participated in this study. All accessed the NeuroSphere Virtual Clinic platform for remote consultations and troubleshooting. A patient satisfaction survey assessed usability, trust, and preference for digital vs in-person consultations. A health economic model analyzed travel costs, CO₂ emissions, and time burdens for in-clinic consultations vs a mixed care pathway across three scenarios of VRCS adoption (20%, 50%, and 100%).</p><p><strong>Results: </strong>The survey results indicated high levels of patient satisfaction, with an average score of 9.1 out of 10, and strong trust in the platform, reported by 98.75% of participants. The introduction of digital consultations led to substantial reductions in travel-related burdens, including a 75% decrease in costs, CO₂ emissions, and travel time during the first year, stabilizing at a 70% reduction in subsequent years. Patients traveling over 500 km experienced the greatest benefits, with annual savings of €525, a reduction of 231 kg in CO₂ emissions, and 19 fewer hours of travel time. The mixed care pathways enhanced accessibility, reducing cancellations and no-shows by up to 59%. Despite increased troubleshooting consultations, hospital resource utilization remained stable, with only marginal increases in workload and space utilization.</p><p><strong>Discussion: </strong>The VRCS aligns with key health care priorities, including improving access, enhancing patient experience, and promoting sustainability. It addresses regional challenges, such as long travel distances and harsh winters, while reducing the ecological footprint of health care delivery. The platform's ability to decrease travel burdens and CO₂ emissions aligns with global sustainability goals. However, barriers such as digital literacy and data privacy require further attention to ensure equitable access.</p><p><strong>Conclusions: </strong>The VRCS demonstrates significant benefits, including high patient satisfaction, reduced travel burdens, and improved resource utilization. By aligning with sustainability objectives, it offers a scalable model for digital transformation in health care, underscoring the importance of continued investment in remote care technologies.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764563","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":"Feasibility and Long-term Outcomes of Minimally Invasive Tubular Spinal Cord Stimulation Lead Placement.","authors":"Allyster B T Klassen, Christine D Potvin, Peggy A Flynn, Vibha Gaonkar, Murray Hong, Susan H Morris, Sean D Christie, Lutz M Weise","doi":"10.1016/j.neurom.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.02.006","url":null,"abstract":"<p><strong>Objectives: </strong>This study primarily addressed the feasibility of implanting a spinal cord stimulation (SCS) electrode in a minimally invasive tubular approach and the required frequency of escalating to a second tube or an open approach. It secondarily addressed the electrode placement in relation to the midline or to the side of the predominant pain, in addition to the long-term clinical outcomes.</p><p><strong>Materials and methods: </strong>A retrospective chart review was conducted in patients who underwent minimally invasive tubular surgery with paddle electrodes for neuropathic pain between January 2017 and December 2023 in Halifax, Canada. Midline placement was assessed anatomically and physiologically with intraoperative imaging and compound muscle action potentials, respectively. Clinical outcomes were described by pre- and postoperative visual analog scale scores, patient satisfaction, and adverse reactions.</p><p><strong>Results: </strong>In total, 25 participants were identified, and all surgeries proceeded without escalation. Anatomically, all but one electrode was placed fully or partially on the spinal midline. Physiologically, muscle activation favored the midline or the predominant pain side in 90% of cases. Four adverse reactions were reported within one year after surgery, one of which was classified as serious. Pre- and postoperative pain scores were significantly reduced from 7.2 ± 1.8 to 4.2 ± 2.5 (p < 0.001); 82.6% of the patients were very satisfied or somewhat satisfied and still using their device one year after surgery.</p><p><strong>Conclusions: </strong>Minimally invasive tubular placement of SCS electrodes is shown here to be feasible, achieving satisfactory alignment and clinical outcomes. The lack of surgical escalation supports the minimally invasive claim. Midline placement was indicated anatomically and physiologically in most cases, and clinical decisions for impactful pain coverage accounted for most nonmidline placements. Clinically, patient-reported outcomes were largely positive.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753106","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":"Transcutaneous Neuromodulation Promotes Functional Regeneration of the External Urethral Sphincter Neural Circuitry in Two Models of Nerve Lesion in Female Rats.","authors":"Ricardo Juárez, José Luis Palacios, Yolanda Cruz","doi":"10.1016/j.neurom.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.02.009","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the effect of transcutaneous electrical stimulation of the dorsal nerve of the clitoris (DNC-TENS) on the functional recovery of the neural circuitry of the external urethral sphincter (EUS) neural circuitry in two models of childbirth trauma in rats: vaginal distension (VD) and injury of the motor branch of the pudendal nerve (MBPN).</p><p><strong>Materials and methods: </strong>In total, 42 Wistar adult female rats were used. Rats underwent sham VD (SH-VD), VD with sham DNC-TENS (VD SH-TENS) or VD with DNC-TENS, bilateral crush of MBPN crush injury (MBPNC) with sham DNC-TENS, or MBPNC with DNC-TENS. Stimulation was delivered to the dorsal region of the clitoral sheath, immediately and on days 2 and 4 after VD or MBPNC. The outcome parameters were EUS electromyograms (EMGs, amplitude and frequency) and cystometrograms (CMGs). Animals were evaluated at seven and 14 days after VD or SH-VD and at day 9 after the nerve crush.</p><p><strong>Results: </strong>In SH-VD animals, the EUS EMG activity increased concurrently with bladder contraction. Tonic and bursting responses also were observed. VD significantly impaired EUS and CMG characteristics in the first week postlesion; in the VD SH-TENS group, the bursting EMG response was abolished; the amplitude of tonic activity decreased (p < 0.0001), and the duration of bladder contraction decreased. DNC-TENS facilitated recovery of bursting and tonic EUS EMG activity after VD (p < 0.0001). As with VD, MBPNC abolished EUS bursting activity and decreased (∼80%) tonic activity. TENS significantly improved EMG and CMG parameters.</p><p><strong>Conclusions: </strong>VD and MBPNC significantly impair EUS EMG activity. DNC-TENS facilitates functional recovery of the EUS neural circuitry by promoting neuroregeneration and increases bladder compliance. Further studies are required to determine whether DNC-TENS is an effective noninvasive neuromodulation therapy to alleviate or prevent symptoms of stress urinary incontinence associated with childbirth trauma in women.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743455","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":"Mapping Healthy and Epileptic States in the Centromedian Nucleus Region.","authors":"David Satzer, Lesley C Kaye, Megan V Ryan, Steven G Ojemann, John A Thompson, Daniel R Kramer","doi":"10.1016/j.neurom.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.02.005","url":null,"abstract":"<p><strong>Background: </strong>Neuromodulation of the centromedian nucleus (CM) has shown beneficial effects on seizure frequency. The effects of stimulation vary by location within the CM region, and during closed-loop stimulation, different contacts have been used for recording and stimulation. The spatial relationships between anatomy, stimulation efficacy, and recording utility remain unclear.</p><p><strong>Materials and methods: </strong>Local field potentials were recorded from participants undergoing responsive neurostimulation targeting the CM for the treatment of epilepsy. Spectral features, including periodic power and aperiodic offset, were derived from baseline recordings. Line length and bandpass detector metrics were calculated from device-detected epileptiform activity and compared with baseline. Spectral and detection features were mapped according to channel locations using coordinates in Montreal Neurological Institute space and spatial reconstruction of local field potential sources.</p><p><strong>Results: </strong>Ten adult participants were studied, including eight with genetic generalized epilepsy, one with Lennox-Gastaut syndrome, and one with multifocal epilepsy. Periodic spectra demonstrated a daytime beta peak and a nighttime alpha/low beta peak. Spatial variation was noted for all spectral and detection features. Daytime aperiodic exponent, daytime periodic beta power, and nighttime periodic alpha power were highest in the medial CM (p < 0.001), with an additional beta spatial maximum in the motor thalamus. Line length detection exhibited a maximum in the posterior CM and was lower near a previously described \"sweet spot\" for stimulation (p < 0.001). Maximal bandpass detection was observed in the lateral CM (p < 0.001), 3 mm away from the stimulation sweet spot.</p><p><strong>Conclusions: </strong>Maximal bandpass detection was observed in the lateral CM, near a previously described stimulation sweet spot. Other spectral and detection features were elevated in the medial/posterior CM, which has been described as a functionally distinct subregion. The lateral CM appears to be a favorable region for detection of epileptiform activity.</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":"143730929","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":"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}