Neuromodulation : journal of the International Neuromodulation Society
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Randomized Controlled Trial
Predictors of implantable pulse generator placement after sacral neuromodulation: who does better?
Numerous studies have documented a relationship between provider variables, including surgeon volume and specialty, and outcomes for surgical procedures. In this study we analyzed claims data from a Medicare database to analyze outcomes of sacral neuromodulation (SNM) with respect to both provider and patient factors. ⋯ The rate of IPG implantation after SNM was greater among high-volume providers. Women had better outcomes than men. Further research may better define the relationship between outcomes of sacral neuromodulation and specific etiology of voiding dysfunction.
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Randomized Controlled Trial
Occipital nerve stimulation in fibromyalgia: a double-blind placebo-controlled pilot study with a six-month follow-up.
The goal of this study is to evaluate the effectiveness of occipital nerve stimulation (ONS) as a surgical treatment for fibromyalgia in a placebo-controlled design. ⋯ Our data strongly suggest that ONS is beneficial in the treatment of fibromyalgia. The beneficial effects are stable at six months after permanent implantation. Subsensory threshold stimulation is feasible in designing a placebo-controlled trial.
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Randomized Controlled Trial
Enhancement of affective processing induced by bifrontal transcranial direct current stimulation in patients with major depression.
Our aim was to evaluate whether one single section of transcranial direct current stimulation (tDCS), a neuromodulatory technique that noninvasively modifies cortical excitability, could induce acute changes in the negative attentional bias in patients with major depression. ⋯ Active but not sham tDCS significantly modified the negative attentional bias. These findings add evidence that a single tDCS session transiently induces potent changes in affective processing, which might be one of the mechanisms of tDCS underlying mood changes.
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Randomized Controlled Trial
A feasibility study to investigate the effect of functional electrical stimulation and physiotherapy exercise on the quality of gait of people with multiple sclerosis.
To examine the effect of Functional Electrical Stimulation (FES) for dropped foot and hip instability in combination with physiotherapy core stability exercises. ⋯ The intervention was feasible. FES for dropped foot may improve mobility and quality of life and may reduce falls. Adding gluteal stimulation further improved gait quality. Adding physiotherapy may have enhanced the effect of FES, but FES had the dominant effect.
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Randomized Controlled Trial Comparative Study
Patient-perceived differences between constant current and constant voltage spinal cord stimulation systems.
Spinal cord stimulation (SCS) systems employ implantable pulse generators that use either a constant current (CC) or a constant voltage (CV) power source. CC power sources adjust voltage in response to resistance (impedance) to ensure that consistent current is delivered to the patient. CV power sources do not adjust voltage in response to impedance; therefore, current delivered to the patient will vary in response to changes in impedance. Both systems produce paresthesia and have been shown to treat chronic pain; however, it has been suggested that patients prefer CC stimulation over CV stimulation. ⋯ The results from this study indicate that patients preferred and experienced greater satisfaction and pain relief with the CC system during an SCS trial period. Differences between the two systems following long-term use has yet to be compared. However, the benefits of the CC system seen with short-term use should be considered when selecting an SCS system.