Neuromodulation : journal of the International Neuromodulation Society
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Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a potential modulator of cognitive behavior that activates the locus coeruleus-noradrenaline (LC-NA) system. Previous studies explored both phasic and tonic taVNS by investigating their impact on LC-NA markers such as pupil dilation and heart rate variability (HRV). ⋯ Our findings suggest that tonic and event-related phasic taVNS may modulate noradrenergic activity, as evidenced by pupil responses and HRV changes during the change-detection task. This study provides new evidence regarding the impact of taVNS on cognitive tasks, thus supporting the development of noninvasive neuromodulation interventions.
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Despite the growing interest in transcranial focused ultrasound stimulation (TUS), our understanding of its underlying mechanisms remains limited. In this study, we aimed to investigate the effects of TUS on several functional magnetic resonance imaging metrics by considering their latency, duration, and relationship with applied acoustic pressure. ⋯ These results suggest that some consequences of TUS might not be immediate, inviting us to revise the premise that TUS consequences are immediate and will progressively disappear.
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Patients with functional dyspepsia often exhibit gastrointestinal motor disorders associated with gastric myoelectrical dysrhythmia. This study investigated the effects of vagal nerve stimulation (VNS) in a rodent model of gastric slow-wave dysrhythmia induced by colorectal distention (CRD). ⋯ VNS using optimal parameters effectively ameliorated CRD-induced gastric dysmotility mediated through the vagal-cholinergic pathway, suggesting that VNS may hold therapeutic potential for functional gastrointestinal disorders.
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Standard anterograde placement of a surgical paddle lead (SPL) for spinal cord stimulation (SCS) can be challenging in patients with scarring from prior spine surgery, instrumentation obstructing the targeted level, or severe stenosis below the targeted level. One potential alternative is retrograde (caudal) insertion by performing laminotomies cephalad to the targeted levels. The literature is limited to only a small number of individual cases describing this technique. In this report, the authors present their experience over the last ten years of the retrograde insertion of SPLs for SCS. ⋯ The retrograde insertion of SPLs is a low-risk and feasible procedure that can be performed with minimal risk of lead migration, fracture, or deep surgical site infection. The retrograde strategy can be used in SPL trials or permanent placements.
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Review Meta Analysis
Cylindrical vs Paddle Leads in Spinal Cord Stimulation for the Long-term Treatment of Chronic Pain: A Systematic Review and Meta-analysis.
This systematic review compares the long-term efficacy of cylindrical-lead spinal cord stimulation (CL-SCS) vs paddle-lead spinal cord stimulation (Paddle-SCS) for chronic pain management. ⋯ Paddle-SCS offers superior pain reduction (as measured by the VAS) and a lower migration rate, but a higher infection risk compared with CL-SCS. CL-SCS showed better outcomes as measured by the NRS. The choice between Paddle-SCS and CL-SCS should be individualized according to patient-specific factors and treatment goals. Further research with rigorous study designs is needed to provide clearer comparisons between these interventions.