Nathan J Pertsch, Kazuki Sakakura, Sepehr Sani, Jay Shils
{"title":"Neuromodulation for Epilepsy.","authors":"Nathan J Pertsch, Kazuki Sakakura, Sepehr Sani, Jay Shils","doi":"10.1080/21646821.2025.2516861","DOIUrl":"10.1080/21646821.2025.2516861","url":null,"abstract":"<p><p>Epilepsy surgery encompasses a wide range of procedures aimed at reducing or eliminating seizures. In these procedures, there are opportunities to employ intraoperative neurophysiology to map the epileptic focus and accurately identify functional areas of the brain. In cases of drug-resistant epilepsy where onset is diffuse, multifocal, or in an eloquent region of the brain, resection is not possible, and neuromodulation can be considered to reduce the seizure burden. While resective or ablative therapy aims to be curative, neuromodulation techniques for epilepsy are generally considered palliative. The goal of neuromodulation is to use an implantable device with electrodes and a pulse generator to use electrical energy to interfere with the nervous system. Three neuromodulation modalities have been approved by the United States FDA for epilepsy: vagus nerve stimulation, deep brain stimulation of the anterior nucleus of the thalamus, and responsive neurostimulation. While rates of seizure freedom with neuromodulation are lower than with resection of an epileptogenic focus, many patients experience >50% reduction in seizures, and results improve with time, suggesting both acute and chronic benefits with these therapies.</p>","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":" ","pages":"287-307"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christina B Swan, Neepa Patel, Sepehr Sani, Jay Shils
{"title":"Optimizing Outcomes: A Review of Pre- and Post-Surgical Evaluations in Deep Brain Stimulation for Parkinson's Disease and Essential Tremor.","authors":"Christina B Swan, Neepa Patel, Sepehr Sani, Jay Shils","doi":"10.1080/21646821.2025.2574104","DOIUrl":"10.1080/21646821.2025.2574104","url":null,"abstract":"<p><p>Deep brain stimulation (DBS) has significantly advanced the treatment of moderate to severe motor symptoms in conditions such as Parkinson's disease and essential tremor. Although DBS is generally considered a safe and effective therapy, selecting suitable candidates requires careful diagnostic evaluation and ensuring a stable neuropsychiatric baseline. Effective patient counseling is crucial, as it helps manage expectations regarding the potential benefits, the limitations of DBS, and the typical timeline for symptom improvement. This counseling is as important as the precision in surgical targeting to achieve optimal therapeutic outcomes. Once DBS is implanted, the remaining adjustable component is the programming of the device, which plays a vital role in patient response. Despite the absence of formal programming algorithms, various studies have provided collective insights into best practices, offering guidance on how to approach device programming for improved results. The aim of this review is to equip clinicians with valuable practical knowledge to enhance the management of patients undergoing DBS therapy, ultimately optimizing patient outcomes. By understanding the complexities of patient selection, surgical placement, and ongoing device management, clinicians can better tailor DBS interventions to individual needs and maximize the long-term benefits of the therapy.</p>","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":" ","pages":"324-351"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zinat S Annaev, Adam F Jackson, Konstantin V Slavin
{"title":"Intraoperative Neuromonitoring in Peripheral Nerve Stimulation.","authors":"Zinat S Annaev, Adam F Jackson, Konstantin V Slavin","doi":"10.1080/21646821.2025.2568818","DOIUrl":"10.1080/21646821.2025.2568818","url":null,"abstract":"<p><p>Peripheral nerve stimulation (PNS) is defined as the application of electric stimulation to the peripheral nervous system and to a specific nerve. For the most part, the goal of PNS has been treatment of pain. Later, PNS use expanded to indications other than pain including epilepsy and depression, which involves stimulation of the vagus nerve, sleep apnea with stimulation of the hypoglossal nerve, respiratory insufficiency, involving phrenic nerve stimulation, and many others. The overarching peripheral neuromodulation approach involves three modalities: conventional PNS, which implies direct placement of stimulating electrode leads over the affected peripheral nerve(s); percutaneous PNS, which implies insertion of stimulating electrode leads near the target nerve with appropriate guidance; and peripheral nerve field stimulation, which requires placement of electrode leads to stimulate smaller nerves and nerve endings in the affected target area. Monitoring peripheral nerves during surgery through electrophysiological methods is a highly valuable option, offering crucial real-time information to the surgical team. While preoperative testing provides helpful data for decision-making, intraoperative neurophysiological monitoring (IONM) fills in gaps that cannot be addressed by preoperative studies. IONM assesses the nervous system during surgery to prevent potential damage to critical neurological structures. It serves the next main purposes: detecting and minimizing iatrogenic injuries, mapping nervous structures to identify the target nerve, and assessing the functionality of the nerve. In this article we review currently available information about the utilization of IONM during PNS procedures.</p>","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":" ","pages":"308-323"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Maureen Berkeley Award and the Theda Sannit Outstanding Educator Award.","authors":"","doi":"10.1080/21646821.2025.2577612","DOIUrl":"https://doi.org/10.1080/21646821.2025.2577612","url":null,"abstract":"","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":"65 4","pages":"371-372"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145655712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spinal Cord Stimulation: Neuromodulation for Intraoperative Neuromonitoring Personnel.","authors":"Rohan J Kurian, Steven Falowski","doi":"10.1080/21646821.2025.2490307","DOIUrl":"10.1080/21646821.2025.2490307","url":null,"abstract":"<p><p>Intraoperative neuromonitoring (IONM) has emerged as a transformative tool in spinal cord stimulation (SCS) and dorsal root ganglion (DRG) procedures, enabling precise lead placement under general anesthesia. It also addresses the safety aspect of placement in an asleep patient while also mitigating the challenges of traditional awake techniques. This paper outlines the protocols and benefits of IONM, with a focus on electromyography (EMG) and somatosensory evoked potentials (SSEP) for real-time guidance during thoracic, cervical, and DRG stimulator placement. It explores how IONM optimizes myotomal-to-dermatomal mapping, improves paresthesia coverage, and enhances outcomes by reducing revision rates. Additionally, the paper evaluates waveform-specific neuromodulation effects, highlighting advancements in personalized pain management through innovative stimulation paradigms and potential mechanisms of action.</p>","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":" ","pages":"264-286"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Maureen Berkeley Award and the Theda Sannit Outstanding Educator Award.","authors":"","doi":"10.1080/21646821.2025.2577612","DOIUrl":"https://doi.org/10.1080/21646821.2025.2577612","url":null,"abstract":"","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":"65 4","pages":"371-372"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}