Neuromodulation : journal of the International Neuromodulation Society
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Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity currents facilitating or inhibiting spontaneous neuronal activity. tDCS is attractive since dose is readily adjustable by simply changing electrode number, position, size, shape, and current. In the recent past, computational models have been developed with increased precision with the goal to help customize tDCS dose. The aim of this review is to discuss the incorporation of high-resolution patient-specific computer modeling to guide and optimize tDCS. ⋯ Though modeling for noninvasive brain stimulation is still in its development phase, it is predicted that with increased validation, dissemination, simplification, and democratization of modeling tools, computational forward models of neuromodulation will become useful tools to guide the optimization of clinical electrotherapy.
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To review the use of noninvasive brain stimulation (NBS) as a therapeutic tool to enhance neuroplasticity following traumatic brain injury (TBI). ⋯ Evidence from animal and human studies reveals the potential benefit of NBS in decreasing the extent of injury and enhancing plastic changes to facilitate learning and recovery of function in lesioned neural tissue. However, this evidence is mainly theoretical at this point. Given safety constraints, studies in TBI patients are necessary to address the role of NBS in this condition as well as to further elucidate its therapeutic effects and define optimal stimulation parameters.
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We reviewed the clinical applications, academic communications, and specialized training required for deep brain stimulation (DBS) in China. Current problems and possible solutions also were discussed. ⋯ DBS has evolved significantly during the past decade in China. There are still several problems. The advent of Chinese homemade DBS hardware, multidisciplinary cooperation, and the establishment of guidelines and regulations for DBS will improve the application of this surgical treatment in China.
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Review
Gastric neuromodulation with Enterra system for nausea and vomiting in patients with gastroparesis.
Gastric electrical stimulation (GES) has been introduced for treating gastric motility disorders, such as gastroparesis, and obesity. A special method of GES using high frequency-short pulses, called Enterra® Therapy, has been clinically applied to treat nausea and vomiting in patients with gastroparesis. However, its mechanisms are not well understood. ⋯ GES with high frequency-short pulses effectively reduces nausea and vomiting in patients with gastroparesis. This antiemetic effect could be mediated via enteric, autonomic, and/or central neural mechanisms. Further systematic and controlled studies are needed to improve the efficacy of Enterra Therapy and to understand its mechanisms of action.
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Review Case Reports
Intrapleural migration of a spinal catheter in a patient with arachnoiditis and extensive epidural scarring after tethered cord release: a case report and review of literature.
The objective of this study was to report a case of new onset refractory pain from intrapleural migration of a spinal catheter five months after the implantation of an intrathecal drug delivery system (IDDS). ⋯ Physicians and nursing staff that place and manage an IDDS should be aware of this complication.