Neuromodulation : journal of the International Neuromodulation Society
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Randomized Controlled Trial Comparative Study
Neuronavigated vs. conventional repetitive transcranial magnetic stimulation method for virtual lesioning on the Broca's area.
This study was undertaken to test the hypothesis that repetitive transcranial magnetic stimulation (rTMS) using a neuronavigational TMS system (nTMS) to the Broca's area would elicit greater virtual aphasia than rTMS using the conventional TMS method (cTMS). ⋯ nTMS leads to more robust neuromodulation of Broca's area, resulting in delayed verbal reaction time as well as more accurate targeting of the intended stimulation location, demonstrating superiority of nTMS over cTMS for therapeutic use of rTMS in neurorehabilitation.
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Randomized Controlled Trial
Neuromodulation of emotion using functional electrical stimulation applied to facial muscles.
Major depressive disorder (MDD) is a common condition for which available pharmaceutical treatments are not always effective and can have side-effects. Therefore, alternative and/or complementary MDD treatments are needed. Research on facial expressions has shown that facial movements can induce the corresponding emotions, particularly when specific attention is paid to voluntarily activating muscles that are typically only activated involuntarily while expressing emotions. We hypothesized that functional electrical stimulation (FES) applied to facial muscles may enhance this effect due to its ability to modulate central nervous system plasticity. Thus, applying FES to the facial muscles associated with smiling (including the "Duchenne marker") may increase the activity of subcortical nuclei related to positive emotions and counteract symptoms of depression. ⋯ These results suggest that modulating emotion using FES may be possible, but is difficult to target accurately. Further work is warranted to explore FES applications to MDD.
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Randomized Controlled Trial Multicenter Study
Peripheral nerve field stimulation for the management of localized chronic intractable back pain: results from a randomized controlled study.
Improved device technology has caused a renewed interest in peripheral nerve field stimulation (PNfS). This study sought to obtain preliminary estimates of the safety and efficacy of PNfS in patients with localized chronic intractable pain of the back. ⋯ A total of 44 patients were enrolled at five sites. Of these patients, 32 were implanted with a trial system and 30 completed phase I. During phase I, there were significant differences in mean VAS scores between minimal stimulation and subthreshold stimulation (p = 0.003), low frequency stimulation (p < 0.001), and standard stimulation (p < 0.001). Twenty-four patients were classified as responders to the therapy, and 23 patients received permanent system placement. Significant differences in VAS scores were observed between baseline and all follow-up visits during phase II (p < 0.001) CONCLUSIONS: The results provide evidence to support safety and effectiveness of PNfS as an aid in the management of chronic, localized back pain.
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Randomized Controlled Trial Multicenter Study
Analgesic efficacy of high-frequency spinal cord stimulation: a randomized double-blind placebo-controlled study.
Spinal cord stimulation is a recognized treatment of chronic neuropathic and vascular pain. Recent data suggest that the use of very high-frequency (HF) stimulation modes does produce analgesia without paresthesia. ⋯ This is the first randomized double-blind study on SCS. HFSCS was equivalent to sham for the primary outcome (improvement of PGIC) as well as for both the secondary outcomes (VAS and EQ-5D index). There was a highly statistically significant "period effect" (p = 0.006) with improved PGIC scores in the first study period regardless of the treatment. The same trend was seen for VAS and EQ-5D. It appears that the effect of HFSCS and sham is equal and only the order in the sequence, not the nature of the treatment, seems to dictate the effect.