Neuromodulation : journal of the International Neuromodulation Society
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Review Meta Analysis
Cost-Effectiveness Modeling of Repetitive Transcranial Magnetic Stimulation Compared to Electroconvulsive Therapy for Treatment-Resistant Depression in Singapore.
Compared to electroconvulsive therapy (ECT), the cost-effectiveness of repetitive transcranial magnetic stimulation (rTMS) in the management of treatment-resistant depression (TRD) remains unclear. ⋯ rTMS was a cost-effective treatment compared to ECT in TRD over one year. The cost-effectiveness of rTMS was attenuated when ECT was used in the outpatient setting.
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High-definition transcranial direct current stimulation (HD-tDCS) using a 4 × 1 electrode montage has been previously shown using modeling and physiological studies to constrain the electric field within the spatial extent of the electrodes. The aim of this proof-of-concept study was to determine if functional near-infrared spectroscopy (fNIRS) neuroimaging can be used to determine a hemodynamic correlate of this 4 × 1 HD-tDCS electric field on the brain. ⋯ The greater O2 Hbint "within" than "outside" the spatial extent of the 4 × 1 electrode montage represents a hemodynamic correlate of the electrical field distribution, and thus provides a prospective reliable method to determine the dose of stimulation that is necessary to optimize HD-tDCS parameters in various applications.
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Persistent mild traumatic brain injury related headache (MTBI-HA) represents a neuropathic pain state. This study tested the hypothesis that repetitive transcranial magnetic stimulation (rTMS) at the left prefrontal cortex can alleviate MTBI-HA and associated neuropsychological dysfunctions. ⋯ A short-course rTMS at the left DLPFC can alleviate MTBI-HA symptoms and provide a transient mood enhancing benefit. Further studies are required to establish a clinical protocol balancing both treatment efficacy and patient compliance.
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Novel paired associative stimulation (novel-PAS), delivered by pairing movement-related cortical potentials (MRCPs) with electrical stimulation of somatosensory afferents, is an innovative neuromodulatory intervention. Novel-PAS results in increased corticomotor excitability and has potential as a rehabilitative adjunct to improve outcomes following stroke. The duration of its excitatory effect has important implications for how this novel PAS intervention might be applied within a traditional therapy session, but previous research has not explored its effects beyond 30 min post-intervention. ⋯ Corticomotor excitability is increased for 60 min following this novel-PAS intervention. Future research could investigate the optimal method of combining this neuromodulatory technique with traditional therapy.
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To assess if transcranial direct current stimulation (tDCS) produces a temperature change at the skin surface, if any change is stimulation polarity (anode or cathode) specific, and the contribution of passive heating (joule heat) or blood flow on such change. ⋯ Taken together, our results indicate a moderate and nonhazardous increase in temperature at the skin surface during 2 mA tDCS that is independent of polarity, and results from stimulation induced blood flow rather than joule heat.