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Brain stimulation and epilepsy: electrical stimulus characteristics
Published in Hans O Lüders, Deep Brain Stimulation and Epilepsy, 2020
Neurostimulation can be thought of as being a tool for treating neurological dysfunction. The particular therapeutic application will determine which part of the nervous system is activated or deactivated by stimulation. There are basic principles associated with the use of neurostimulation which aid the clinician in predicting the effects of using different stimulation parameters in a safe manner with the desired outcome.
From assessment to intervention
Published in Rosa Angela Fabio, Tindara Caprì, Gabriella Martino, Understanding Rett Syndrome, 2019
Rosa Angela Fabio, Tindara Caprì, Gabriella Martino
The neurostimulation techniques can influence specific parts of the brain by activation or inhibition of their functionality. Many neurological and psychiatric disorders are correlated to a hyperfunction or hypofunction of specific areas of the nervous system; neurostimulation methods represent a therapeutic possibility which is based on the principle of the normalization of the activity in the dysfunctional areas. Hence, we talk about “neuromodulation” i.e. the application of neurostimulation techniques with the aim to reactivate the normal activity or function of specific dysfunctional areas or structures of the brain.
Restoration: Nanotechnology in Tissue Replacement and Prosthetics
Published in Harry F. Tibbals, Medical Nanotechnology and Nanomedicine, 2017
Nanofabrication is increasing the resolution and capabilities of neurostimulation devices. Neurostimulation is used medically for cardiac pacemaking, deep brain stimulation to control tremors in Parkinson’s disease, management of chronic pain, stimulation of tissue healing, prevention and reversal of nerve degeneration, and other conditions and therapies, including chronic neuropathy, diabetic neuroarthropathy, and cardiomyoplasty.
Current and future pharmacotherapy options for drug-resistant epilepsy
Published in Expert Opinion on Pharmacotherapy, 2022
Are any of these drugs going to change the treatment of epilepsy? This is difficult to tell. ASMs still represent the main treatment for epilepsy, but they are not the only option. Surgical techniques are advancing as well as research into neurostimulation. This will reinforce the need to identify good outcome measures. In terms of seizure-based outcomes, the definition of drug-resistance proposed by the ILAE introduced a few important points such as the duration of the observation and the relapsing remitting nature of some epilepsy syndromes. It goes without saying that the short follow-up provided by regulatory trials is insufficient to gain any information on the usefulness of specific compounds in the long term. In this regard, phase IV trials will be needed but will need to adopt the same criteria in terms of seizure freedom and comparable outcome measures. In addition to seizure-based outcomes, it is important to recognize that that several factors beyond seizure frequency are relevant for patients with drug-resistant epilepsy and these include comorbidities, especially cognitive and psychiatric ones. Potentially, this could lead to the development of new compounds targeting specific comorbidities in addition to seizures, but none of the drugs currently under development appear to address this issue.
Can we use the dynamic and complex interplay between pain and sleep to quantify neuromodulation responsiveness for chronic pain?
Published in Expert Review of Neurotherapeutics, 2021
Thomas Kinfe, Michael Buchfelder, Andreas Stadlbauer
To date, robustly designed (randomized-controlled) human studies are increasingly evaluating noninvasive and invasive neurostimulation therapies (e.g. deep brain stimulation, motor cortex stimulation, transcranial magnetic stimulation, transcranial direct current stimulation, transcranial alternating stimulation, cervical noninvasive vagus nerve stimulation, different spinal cord stimulation waveforms and dorsal root ganglion stimulation) for refractory chronic pain disorders, such as primary headache disorders, lower back pain, neuropathic leg pain and complex regional pain syndrome [7–13]. These studies have underscored the usefulness of neurostimulation as an adjunctive treatment strategy for use with pharmacological-behavioral therapies. However, none of these studies have incorporated objective sleep measures, such as polysomnography, actinography, electromyography or electroencephalography [7–13].
Dimensions of Ethical Direct-to-Consumer Neurotechnologies
Published in AJOB Neuroscience, 2019
One type of DTC neurotechnology that may present a safety risk is a neurostimulation device. Consider, for example, tDCS neurostimulation devices such as the Thync Relax Pro (Langley 2017) or the foc.us Go Flow 4 (Focus Go Flow 2018). Such devices deliver low-intensity electric currents to an area of the brain in an attempt to facilitate or inhibit neuronal activity in that area (Brunoni et al. 2012). In this way they seek to modulate brain functioning, and, according to providers, improve cognition, relieve symptoms of anxiety and depression, combat cravings, and enhance meditation (Landhuis 2017). There are, however, risks associated with this technology. These include that unintended areas may be affected, that enhancing one area might hurt another, that effects may be longer-lasting than expected, that tDCS may impair working memory, and that tDCS may cause contact dermatitis and skin burns (Riedel et al. 2012; Steenbergen et al. 2016; Wurzman et al. 2016).