Neuromodulation : journal of the International Neuromodulation Society
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The effects of spinal cord stimulation (SCS) on the spinal γ-amino butyric acid (GABA) system have previously been studied in animal models of neuropathic pain. These studies, confirming the pivotal role of segmental GABA actions for the efficacy of SCS, have led to the question if the disturbance of the GABA inhibitory system as demonstrated both in basal and clinical studies also encompasses malfunction of the GABA synthesis. ⋯ Although GABAergic mechanisms are closely related to the effects of SCS, the presence of neuropathic signs and their suppression by SCS are not associated with changes of the general levels of the spinal DH GABA-synthesizing enzymes. However, in SCS responding animals, there was a significant increased expression of GAD 65 in lamina II, presumably reflecting an augmented GABA synthesis following SCS.
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The latest generation of rechargeable implantable programmable generators (IPGs) for spinal cord stimulation may greatly extend IPG lifespan compared with previous nonrechargeable devices. This study explores patients' experiences with these devices. ⋯ Patients found the rechargeable IPG easy to recharge and those who had had previous experience with nonrechargeable devices preferred using the rechargeable device. Its benefits in terms of pain relief fell within the range expected from previous studies using nonrechargeable batteries. The main disadvantage of nonrechargeable devices as reported by the patients in this study was concern over the length of time they would have to wait without pain relief between battery replacements.
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To observe the effect of low-frequency hippocampal stimulation on gamma-amino butyric acid type B (GABA-B) receptor expression in hippocampus pharmacoresistant epileptic rats. ⋯ The low-frequency hippocampal stimulation may inhibit the amygdale stimulus-induced epileptic seizures and the after discharges. The antiepileptic effects of the hippocampal stimulation may be achieved partly by increasing the expression of the GABA-B receptor.
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We describe the electrocorticographic findings after hippocampal stimulation in normal awake rats. ⋯ Bilateral hippocampal and cortical recruiting responses were easily obtained in all animals after low-frequency hippocampal unilateral stimulation. High-frequency stimulation did not give rise to recruiting response, although a DC shift was noted. The fact that unilateral hippocampal stimulation might lead to bilateral limbic system modulation suggested that unilateral stimulation might be enough in many situations. Our findings suggested that high-frequency stimulation was more likely to be effective than low-frequency stimulation regarding the potential inactivation of the hippocampus. These findings might prove relevant to the determination of the adequate parameters for stimulation using hippocampal deep brain stimulation (DBS) in the future. An increase in our knowledge on the physiologic mechanisms underlying DBS might be translated into more rational clinical approaches.