Neuromodulation : journal of the International Neuromodulation Society
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Randomized Controlled Trial
Reducing transcranial direct current stimulation-induced erythema with skin pretreatment: considerations for sham-controlled clinical trials.
Transcranial direct current stimulation (tDCS)-induced erythema (skin reddening) has been described as an adverse effect that can harm blinding integrity in sham-controlled designs. To tackle this issue, we investigated whether the use of topical pretreatments could decrease erythema and other adverse effects associated with tDCS. ⋯ Ketoprofen 2% topical pretreatment might be an interesting strategy to reduce tDCS-induced erythema and might be useful for blinding improvement in further sham-controlled tDCS trials.
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To investigate intrafascicular pudendal nerve stimulation in felines as a means to restore urinary function in acute models of urinary incontinence, overactive bladder, and underactive bladder. ⋯ Multielectrode arrays implanted intrafascicularly into the pudendal nerve trunk may provide a promising new clinical neuromodulation therapy for the restoration of urinary function.
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Hemiplegic migraine is a particularly severe form of the disease that often evolves to a debilitating chronic illness that is resistant to commonly available therapies. Peripheral neurostimulation has been found to be a beneficial therapy for some patients among several diagnostic classes of migraine, but its potential has not been specifically evaluated for hemiplegic migraine. ⋯ Concordant combined occipital and supraorbital neurostimulation may provide effective therapy for both the pain and motor aura in some patients with hemiplegic migraine.
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Lead fracture is a common and troublesome hardware-related complication in deep brain stimulation therapy. Frequent cervical movements are suspected as the main cause, but the underlying mechanisms are still unclear. We propose the integrity of the helical structure of the lead wires is important and conduct systematic experiments to demonstrate this. We aim to provide a new view on how lead fracture takes place. ⋯ We demonstrate that integrity of the helical structure of the wires is crucial to the fatigue performance of the lead. Although the results cannot be directly extrapolated to human subjects, they suggest a possible lead fracture mechanism. The implanted lead may undergo deformation due to large-amplitude motions (e.g., falls) and develop fracture due to the deterioration in fatigue resistance, especially when it is placed at or migrates to the neck. It may be possible to effectively protect the lead by using certain surgical techniques during implantation, such as placing the connector on the calvaria or in a drilled trough at the retroauricular region with reliable fixation.