Brain Stimul
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Controlled Clinical Trial
Neurophysiologic effects of transcutaneous auricular vagus nerve stimulation (taVNS) via electrical stimulation of the tragus: A concurrent taVNS/fMRI study and review.
Electrical stimulation of the auricular branch of the vagus nerve (ABVN) via transcutaneous auricular vagus nerve stimulation (taVNS) may influence afferent vagal networks. There have been 5 prior taVNS/fMRI studies, with inconsistent findings due to variability in stimulation targets and parameters. ⋯ Stimulation of the tragus activates the cerebral afferents of the vagal pathway and combined with our review of the literature suggest that taVNS is a promising form of VNS. Future taVNS/fMRI studies should systematically explore various parameters and alternative stimulation targets aimed to optimize this novel form of neuromodulation.
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Randomized Controlled Trial
Transcranial Direct Current Stimulation (tDCS) paired with a decision-making task reduces risk-taking in a clinically impulsive sample.
Impulsivity is a multidimensional personality trait observed across a variety of psychiatric disorders. Transcranial direct current stimulation (tDCS) applied over dorsolateral prefrontal cortex (DLPFC) has shown promise as an intervention to reduce impulsivity. ⋯ tDCS over DLPFC paired with a decision-making task effectively reduced risk-taking behavior in a group of Veterans with clinically-relevant impulsivity. Results suggest that this approach may be an effective neuroplasticity-based intervention for patients affected by impulsivity.
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Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) is an emerging experimental therapy for treatment-resistant depression. New developments in SCC DBS surgical targeting are focused on identifying specific axonal pathways for stimulation that are estimated from preoperatively collected diffusion-weighted imaging (DWI) data. However, brain shift induced by opening burr holes in the skull may alter the position of the target pathways. ⋯ Brain shift is an important concern for SCC DBS surgical targeting and can impact connectomic analyses.
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The cerebellum is involved in the pathophysiology of many movement disorders and its importance in the field of neuromodulation is growing. ⋯ Cerebellar modulation can improve specific symptoms in some movement disorders and is a safe and well-tolerated procedure. Further studies are needed to lay the groundwork for new researches in this promising target.
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The impact of comorbid borderline personality disorder (BPD) or post-traumatic stress disorder (PTSD) on clinical and cognitive outcomes of electroconvulsive therapy (ECT) in patients with major depressive episodes (MDE) is unknown. ⋯ Despite a lower c-CGI response for inpatients with MDE + BPD, ECT is a viable treatment option for patients in the MDE + BPD/PTSD group with similar adverse cognitive effect profiles to MDE-only.