Neuromodulation : journal of the International Neuromodulation Society
-
Spinal cord stimulation devices control energy by generating either constant voltage (CV) pulses or constant current (CC) pulses. This study aimed to investigate: 1) whether patients feel differences between CV and CC stimulation; 2) if patients prefer CV or CC stimulation. ⋯ The lack of patient ability to discriminate in this preliminary investigation suggests that patient preference for a stimulation type should not be the key determining factor in choosing a spinal cord stimulation system.
-
In the present investigation, we applied the whole-hand transcutaneous electrical nerve stimulation (TENS) therapy to two incomplete tetraplegic subjects and assessed their progress with four evaluation methods. ⋯ From the comparison of four evaluation methods, it is evident that different assessments and measurements should be used in order to get better picture of patient's upper extremity impairment.
-
Deep brain stimulation technology now allows a choice between constant current and constant voltage stimulation, yet clinical trials comparing the two are lacking. Impedance instability would theoretically favor constant current stimulation; however, few publications address this with long-term follow-up. In this report, we review our series for impedance change and discuss our findings and their implications for future study design. ⋯ No significant change in the same electrode therapeutic impedance was identified. Given the assumption that stimulation current is the critical parameter influencing clinical outcomes, these findings would not disadvantage constant voltage stimulation. However, inter-patient variability suggests a possible advantage for constant current stimulation when generalizing experience and comparisons over multiple patients. Further study of the relationship of stimulation efficacy to stimulation mode and impedance change is warranted.
-
Failed back surgery syndrome (FBSS) patients experience pain, functional disability, and reduced health-related quality of life (HRQoL) despite anatomically successful surgery. Examining sub-dimensions of health outcomes measures provides insight into patient well-being. ⋯ Longer-term patient management and research must focus on these refractory FBSS patients with persisting poor function and HRQoL outcomes.
-
It has been known for decades that neurons in vitro and in vivo respond in a polarity-specific manner to changes in their electrical environment. Likewise, investigators have passed direct current (DC) across the human head for decades in attempts to alter brain function and behavior. Recent human data, however, have put this technique on a more solid empirical footing and it has re-emerged from obscurity as a "new," noninvasive means of neuromodulation, called transcranial direct current stimulation (TDCS). ⋯ The field is very young and many findings will require replication. Nevertheless, TDCS appears to have the potential to be a simple and safe means of neuromodulation.