Neuromodulation最新文献

{"title":"Intrathecal Drug Delivery for Intractable Pain: Identified Patient Satisfaction Survey Study Comparing Intrathecal Dose With Satisfaction, Pain Relief, and Side Effects.","authors":"David M Schultz, Caitlin H Bakke, Hannah L Ruble, Collin S Larmour, Jonathan M Hagedorn, Alaa Abd-Elsayed","doi":"10.1016/j.neurom.2024.11.006","DOIUrl":"10.1016/j.neurom.2024.11.006","url":null,"abstract":"<p><strong>Objectives: </strong>Past studies have shown the efficacy of spinal targeted drug delivery (TDD) in pain relief, reduction in opioid use, and cost-effectiveness in long-term management of complex chronic pain. We conducted a survey to determine treatment variables associated with patient satisfaction.</p><p><strong>Materials and methods: </strong>Patients in a single pain clinic who were implanted with Medtronic pain pumps to relieve intractable pain were identified from our electronic health record. From November 2021 to February 2023, 973 patients with active TDD were identified; 564 completed the 23-question survey, and 560 were included in analyses. Most patients (96.4%) had intrathecal (IT) infusion admixtures containing bupivacaine and opioid. The survey compared satisfaction with IT medication dosages, pain relief, pain diagnosis, catheter tip location, side effects, mental clarity, physical functioning, and healthcare utilization. Outcomes were reported as proportions; p < 0.05 was considered significant.</p><p><strong>Results: </strong>Most respondents reported good-to-excellent pain relief (63.8%), high satisfaction with TDD (80.7%), improvement in physical functioning (75.0%), and better quality of life (89.7%); 78.5% of respondents reported complete discontinuation or substantial reductions in systemic opioid use. There was a statistically significant relationship between satisfaction and IT medication dose (p = 0.02), with the average dose increasing with higher satisfaction groups. We found that patients on higher doses of IT opioids did not have more bothersome side effects (p = 0.05).</p><p><strong>Conclusions: </strong>Our data show that the most satisfied respondents had higher IT doses, fewer side effects, and longer duration of TDD therapy. This suggests that higher dose IT admixtures are safe and effective at relieving pain and improving quality of life in patients with complex chronic pain whose condition has failed to respond adequately to other treatments. TDD may be an effective alternative to long-term systemic opioids for well-selected patients willing to accept the risks of invasive procedures.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932458","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":"IS052 INTRATHECAL DRUG DELIVERY (ITDD) SHALL REMAIN AN RCT FREE ZONE: THE CHALLENGES OF RESEARCH IN ITDD – ITDD DAY","authors":"Sam Eldabe FRCA","doi":"10.1016/j.neurom.2024.09.061","DOIUrl":"10.1016/j.neurom.2024.09.061","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 1","pages":"Page S28"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102179","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":"O003 SPATIO-DIRECTIONAL TUNING OF EVOKED RESONANT NEURAL ACTIVITY WITH DEEP BRAIN STIMULATION IN PARKINSON’S DISEASE","authors":"Kara Johnson PhD ,&nbsp;Jackson Cagle PhD ,&nbsp;Justin Hilliard MD ,&nbsp;Kelly Foote MD ,&nbsp;Coralie De Hemptinne PhD","doi":"10.1016/j.neurom.2024.09.104","DOIUrl":"10.1016/j.neurom.2024.09.104","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 1","pages":"Pages S51-S52"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102242","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":"IS016 POTENTIAL MECHANISMS OF NOVEL NEUROMODULATION TECHNOLOGIES / THERAPY","authors":"Andrei Sdrulla PhD","doi":"10.1016/j.neurom.2024.09.025","DOIUrl":"10.1016/j.neurom.2024.09.025","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 1","pages":"Page S9"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102535","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":"IS001 TRANSCRANIAL DIRECT CURRENT STIMULATION FOR INFLAMMATORY AND POST-INFECTION DISORDERS","authors":"Giuseppina Pilloni PhD,&nbsp;Leigh Charvet PhD","doi":"10.1016/j.neurom.2024.09.010","DOIUrl":"10.1016/j.neurom.2024.09.010","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 1","pages":"Page S1"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102639","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 Effects of Transcranial Direct Current Stimulation and Exercise on Salivary S100B Protein Indicated Blood-Brain Barrier Permeability: A Pilot Study","authors":"Aidan Lewis BS Hons ,&nbsp;Constantino Toufexis BS Hons ,&nbsp;Chloe Goldsmith PhD ,&nbsp;Rebecca Robinson BS ,&nbsp;Grace Howie BS Hons ,&nbsp;Ben Rattray PhD ,&nbsp;Andrew Flood PhD","doi":"10.1016/j.neurom.2023.11.006","DOIUrl":"10.1016/j.neurom.2023.11.006","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the effect of transcranial direct current stimulation (tDCS) and exercise on blood-brain barrier (BBB) permeability in humans as assessed through the quantification of the salivary protein biomarker S100B. It was hypothesized that active tDCS would induce a significant increase in salivary S100B concentration when compared with sham stimulation and no stimulation. It also was hypothesized that the increase in salivary S100B concentration would be greater after active tDCS and exercise than after tDCS or exercise alone.</div></div><div><h3>Materials and Methods</h3><div>A total of 13 healthy adults (five male, eight female), ranging in age from 21 to 32 years, underwent three experimental conditions (active tDCS, sham tDCS, inactive control). To assess exercise- and tDCS-induced changes in BBB permeability, S100B in saliva was measured. Saliva samples were taken before tDCS, after tDCS, and immediately after a ramped cycling time-to-exhaustion (TTE) task. Active tDCS involved the application of anodal stimulation over the primary motor cortex for 20 minutes at 2 mA.</div></div><div><h3>Results</h3><div>S100B concentrations in the control condition did not differ significantly from the active condition (estimate = 0.10, SE = 0.36, <em>t</em> = 0.27, <em>p</em> = 0.79) or the sham condition (estimate = 0.33, SE = 0.36, <em>t</em> = 0.89, <em>p</em> = 0.38). Similarly, S100B concentrations at baseline did not differ significantly from post-intervention (estimate = −0.35, SE = 0.34, <em>t</em> = −1.03, <em>p</em> = 0.31) or post-TTE (estimate = 0.66, SE = 0.34, <em>t</em> = 1.93, <em>p</em> = 0.06).</div></div><div><h3>Conclusions</h3><div>This research provides novel insight into the effect of tDCS and exercise on S100B-indicated BBB permeability in humans. Although the effects of tDCS were not significant, increases in salivary S100B after a fatiguing cycling task may indicate exercise-induced changes in BBB permeability.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 1","pages":"Pages 76-85"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139066416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mechanistic Analysis of the Neural Modulation of the Inflammatory System Through Vagus Nerve Stimulation: A Systematic Review and Meta-analysis","authors":"Paulo S. de Melo MD ,&nbsp;Anna C. Gianlorenco PT, PhD ,&nbsp;Anna Marduy MD ,&nbsp;Chi K. Kim MD, PhD ,&nbsp;Hyuk Choi MD, PhD ,&nbsp;Jae-Jun Song MD, PhD ,&nbsp;Felipe Fregni MD, PhD","doi":"10.1016/j.neurom.2024.03.002","DOIUrl":"10.1016/j.neurom.2024.03.002","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to conduct a systematic review and meta-analysis assessing the antiinflammatory effects of various VNS methods while exploring multiple antiinflammatory pathways.</div></div><div><h3>Materials and Methods</h3><div>We included clinical trials that used electrical stimulation of the vagus nerve and assessed inflammatory markers up to October 2022. We excluded studies lacking control groups, those with combined interventions, or abstracts without full text. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews. For each inflammatory marker, a random-effects meta-analysis using the inverse variance method was performed. Methods used include transcutaneous auricular VNS (taVNS), transcutaneous cervical VNS (tcVNS), invasive cervical VNS (iVNS), and electroacupuncture VNS (eaVNS). Main reported outcomes included tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-1ß, C-reactive protein (CRP), and IL-10. Risk of bias was evaluated using the Cochrane Collaboration Tool (RoB 2.0).</div></div><div><h3>Results</h3><div>This review included 15 studies, involving 597 patients. No statistically significant general VNS effect was observed on TNF-α, IL-6, and IL-1ß. However, CRP, IL-10, and interferon (IFN)-γ were significantly modulated by VNS across all methods. Subgroup analysis revealed specific stimulation techniques producing significant results, such as taVNS effects in IL-1ß and IL-10, and iVNS in IL-6, whereas tcVNS and eaVNS did not convey significant pooled results individually. Cumulative exposure to VNS, higher risk of bias, study design, and pulse width were identified as effect size predictors in our meta-regression models.</div></div><div><h3>Conclusions</h3><div>Pooling all VNS techniques indicated the ability of VNS to modulate inflammatory markers such as CRP, IL-10, and IFN-γ. Individually, methods such as taVNS were effective in modulating IL-1ß and IL-10, whereas iVNS modulated IL-6. However, different VNS techniques should be separately analyzed in larger, homogeneous, and powerful studies to achieve a clearer and more consistent understanding of the effect of each VNS method on the inflammatory system.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 1","pages":"Pages 43-53"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141096918","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 Comprehensive Review of Low-Intensity Focused Ultrasound Parameters and Applications in Neurologic and Psychiatric Disorders","authors":"Stewart S. Cox MD, PhD,&nbsp;Dillon J. Connolly BS,&nbsp;Xiaolong Peng PhD,&nbsp;Bashar W. Badran PhD","doi":"10.1016/j.neurom.2024.07.008","DOIUrl":"10.1016/j.neurom.2024.07.008","url":null,"abstract":"<div><h3>Objectives</h3><div>Low-intensity focused ultrasound (LIFU) is gaining increased interest as a potential therapeutic modality for a range of neuropsychiatric diseases. Current neuromodulation modalities often require a choice between high spatial fidelity or invasiveness. LIFU is unique in this regard because it provides high spatial acuity of both superficial and deep neural structures while remaining noninvasive. This new form of noninvasive brain stimulation may provide exciting potential treatment options for a variety of neuropsychiatric disorders involving aberrant neurocircuitry within deep brain structures, including pain and substance use disorders. Furthermore, LIFU is compatible with noninvasive neuroimaging techniques, such as functional magnetic resonance imaging and electroencephalography, making it a useful tool for more precise clinical neuroscience research to further understand the central nervous system.</div></div><div><h3>Materials and Methods</h3><div>In this study, we provide a review of the most recent LIFU literature covering three key domains: 1) the history of focused ultrasound technology, comparing it with other forms of neuromodulation, 2) the parameters and most up-to-date proposed mechanisms of LIFU, and finally, 3) a consolidation of the current literature to date surrounding the clinical research that has used LIFU for the modification or amelioration of several neuropsychiatric conditions.</div></div><div><h3>Results</h3><div>The impact of LIFU including poststroke motor changes, pain, mood disorders, disorders of consciousness, dementia, and substance abuse is discussed.</div></div><div><h3>Conclusions</h3><div>Although still in its infancy, LIFU is a promising tool that has the potential to change the way we approach and treat neuropsychiatric disorders. In this quickly evolving field, this review serves as a snapshot of the current understanding of LIFU in neuropsychiatric research.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 1","pages":"Pages 1-15"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IS091 DECIPHERING VAGAL ANATOMY AND BRAIN-BODY SIGNALING TO OPTIMIZE NEUROMODULATION THERAPIES","authors":"Theodoros Zanos PhD","doi":"10.1016/j.neurom.2024.09.100","DOIUrl":"10.1016/j.neurom.2024.09.100","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 1","pages":"Page S48"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143092028","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":"IS038 IS THERE ANY INDICATION FOR SPINAL CORD STIMULATION (SCS) AND DORSAL ROOT GANGLION (DRG) IN REFRACTORY BRACHIAL PLEXUS PAIN?","authors":"Jan Vesper MD","doi":"10.1016/j.neurom.2024.09.047","DOIUrl":"10.1016/j.neurom.2024.09.047","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 1","pages":"Page S20"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143097394","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}