Progress in Neurobiology, Journal Year: 2025, Volume and Issue: 249, P. 102770 - 102770
Published: April 19, 2025
Language: Английский
Frontiers in Integrative Neuroscience, Journal Year: 2024, Volume and Issue: 18
Published: Feb. 19, 2024
Bioelectronic Medicine stands as an emerging field that rapidly evolves and offers distinctive clinical benefits, alongside unique challenges. It consists of the modulation nervous system by precise delivery electrical current for treatment conditions, such post-stroke movement recovery or drug-resistant disorders. The unquestionable impact is underscored successful translation to humans in last decades, long list preclinical studies. Given emergency accelerating progress new neuromodulation treatments (i.e., hypertension, autoimmune degenerative diseases), collaboration between multiple fields imperative. This work intends foster multidisciplinary bring together different provide fundamental basis underlying Medicine. In this review we will go from biophysics cell membrane, which consider inner core neuromodulation, patient care. We discuss recently discovered mechanism neurotransmission switching how it design, update on neuronal glial health disease. advances biomedical technology have facilitated collection large amounts data, thereby introducing challenges data analysis. approaches high throughput analysis, encompassing big networks, artificial intelligence, internet things. Emphasis be placed understanding electrochemical properties neural interfaces, along with integration biocompatible reliable materials compliance regulations translational applications. Preclinical validation foundational process, critical aspects animal Finally, focus point-of-care ultimate goal bioelectronic medicine. a call scientists common endeavor: accelerate decoding era therapeutic possibilities.
Language: Английский
Citations
16
Epilepsia, Journal Year: 2022, Volume and Issue: 63(10), P. 2445 - 2460
Published: June 14, 2022
Neuromodulation is a key therapeutic tool for clinicians managing patients with drug-resistant epilepsy. Multiple devices are available long-term follow-up and real-world experience. The aim of this review to give practical summary neuromodulation techniques guide the selection modalities, focusing on patient devices, common approaches initiation programming, outpatient management issues. Vagus nerve stimulation (VNS), deep brain anterior nucleus thalamus (DBS-ANT), responsive neurostimulation (RNS) all supported by randomized controlled trials that show safety significant impact seizure reduction, as well suggestion reduction in risk sudden unexplained death epilepsy (SUDEP). Significant reductions observed after 3 months DBS, RNS, VNS trials, efficacy appears improve time out 7 10 years albeit uncontrolled or retrospective studies. A number experience seizure-free intervals 6 more three modalities. Number location epileptogenic foci important factors affecting efficacy, together comorbidities such severe mood sleep disorders, may influence choice modality. Programming has evolved-DBS typically initiated at lower current/voltage than used pivotal trial, whereas target charge density however generalizable optimal parameters yet be defined. Noninvasive an emerging modality, although it currently not widely. In summary, clinical practice evolved from those established trials. Guidance now who wish expand their approach, technique tailored individual based characteristics, tolerance, preferences.
Language: Английский
Citations
68
Epilepsia, Journal Year: 2023, Volume and Issue: 64(4), P. 811 - 820
Published: Feb. 2, 2023
There are three neurostimulation devices available to treat generalized epilepsy: vagus nerve stimulation (VNS), deep brain (DBS), and responsive (RNS). However, the choice between them is unclear due lack of head-to-head comparisons. A systematic comparison outcomes in epilepsy has not been performed previously. The goal this meta-analysis was determine whether one these better than others epilepsy.Following PRISMA (Preferred Reporting Items for Systematic Reviews Meta-Analyses) guidelines, a review PubMed, Embase, Web Science studies reporting seizure following VNS, RNS, DBS implantation drug-resistant first pivotal trial study each modality through August 2022. Specific search criteria were used VNS ("vagus", "vagal", or "VNS" title "epilepsy" "seizure"), ("deep stimulation", "DBS", "anterior thalamic nucleus", "centromedian "thalamic stimulation" RNS ("responsive neurostimulation" "RNS" "seizure"). From 4409 articles identified, 319 underwent full-text reviews, 20 included. Data pooled using random-effects model meta package R.Sufficient data from seven (n = 510) nine 87). (five studies, n 18) insufficient meta-analysis. mean (SD) follow-up durations as follows: 39.1 (23.4) months; DBS, 23.1 (19.6) 22.3 (10.6) months. Meta-analysis showed reductions 48.3% (95% confidence interval [CI] 38.7%-57.9%) 64.8% CI 54.4%-75.2%) (p .02).Our indicates that use may lead greater reduction epilepsy. Results promising, but further research required.
Language: Английский
Citations
33
Brain, Journal Year: 2023, Volume and Issue: unknown
Published: Oct. 4, 2023
In patients with drug-resistant epilepsy, electrical stimulation of the brain in response to epileptiform activity can make seizures less frequent and debilitating. This therapy, known as closed-loop responsive neurostimulation (RNS), aims directly halt seizure via targeted a burgeoning seizure. Rather than immediately stopping they start, many RNS implants produce slower, long-lasting changes dynamics that better predict clinical outcomes. Here we hypothesize during states drives long-term restore healthy networks. To test this, quantified episodes low- high-risk states-that is, periods lower or higher risk generating activity-in cohort 40 treated RNS. More tonic low-risk out rhythmic predicted reduction. Additionally, events were more likely be phase-locked prolonged abnormal for intermediate poor responders when compared super-responders, consistent hypothesis improved outcomes are driven by states. These results support might underlie mechanisms RNS, suggesting relationship between temporal patterns neuromodulation plasticity facilitates
Language: Английский
Citations
27
Epilepsy & Behavior, Journal Year: 2023, Volume and Issue: 142, P. 109182 - 109182
Published: March 25, 2023
Language: Английский
Citations
24
Brain stimulation, Journal Year: 2024, Volume and Issue: 17(5), P. 1001 - 1004
Published: Aug. 23, 2024
Language: Английский
Citations
10
Nature Communications, Journal Year: 2022, Volume and Issue: 13(1)
Published: Dec. 13, 2022
Deep brain stimulation (DBS) is a promising neuromodulation therapy, but the neurophysiological mechanisms of DBS remain unclear. In awake mice, we performed high-speed membrane voltage fluorescence imaging individual hippocampal CA1 neurons during delivered at 40 Hz or 140 Hz, free electrical interference. powerfully depolarized somatic potentials without suppressing spike rate, especially Hz. Further, paced and timing frequency reduced timed spiking output in response to network theta-rhythmic (3-12 Hz) activity patterns. To determine whether directly impacts cellular processing inputs, optogenetically evoked depolarization soma. We found that DBS-evoked was correlated with DBS-mediated suppression neuronal responses optogenetic inputs. These results demonstrate produces powerful interferes ability respond creating an informational lesion.
Language: Английский
Citations
31
Scientific Reports, Journal Year: 2023, Volume and Issue: 13(1)
Published: July 24, 2023
Abstract The intralaminar nuclei of the thalamus play a pivotal role in awareness, conscious experience, arousal, sleep, vigilance, as well cognitive, sensory, and sexual processing. Nonetheless, humans, little is known about direct involvement these such multifaceted functions their structural connections brain. Thus, examining versatility connectivity with rest brain seems reasonable. Herein, we attempt to show diencephalic, mesencephalic, cortical areas using probabilistic tracking diffusion data from human connectome project. fiber distributions span wide range subcortical areas. Moreover, central medial parafascicular nucleus reveal similar temporal, visual, frontal cortices only slight variability. lateral displays refined projection superior colliculus fornix. centromedian be an essential component somatosensory system, it mainly via cerebellar peduncle brainstem lobules. subparafascicular projects processing It interesting note that all have brainstem. In brief, aligns core various functional demands for emotion, cognition, vision, motor This study sheds light on our understanding structures, which great interest broader audience clinical neuroscience research.
Language: Английский
Citations
19
Stroke and Vascular Neurology, Journal Year: 2023, Volume and Issue: 8(5), P. 368 - 378
Published: March 7, 2023
Deep brain stimulation (DBS) has been preliminarily applied to treat patients with disorders of consciousness (DoCs). The study aimed determine whether DBS was effective for treating DoC and identify factors related patients' outcomes.Data from 365 DoCs who were consecutively admitted 15 July 2011 31 December 2021 retrospectively analysed. Multivariate regression subgroup analysis performed adjust potential confounders. primary outcome improvement in at 1 year.An overall year achieved 32.4% (12/37) the group compared 4.3% (14/328) conservative group. After full adjustment, significantly improved (adjusted OR 11.90, 95% CI 3.65-38.46, p<0.001). There a significant treatment×follow up interaction (H=14.99, had better effects minimally conscious state (MCS) vegetative state/unresponsive wakefulness syndrome (p <0.001). A nomogram based on age, consciousness, pathogeny duration indicated excellent predictive performance (c-index=0.882).DBS associated outcomes DoC, effect likely be greater MCS. should cautiously evaluated by preoperatively, randomised controlled trials are still needed.
Language: Английский
Citations
18
Progress in Biomedical Engineering, Journal Year: 2023, Volume and Issue: 5(1), P. 013002 - 013002
Published: Jan. 1, 2023
Abstract Bioelectronic medicine treats chronic diseases by sensing, processing, and modulating the electronic signals produced in nervous system of human body, labeled ‘neural signals’. While circuits have been used for several years this domain, progress microelectronic technology is now allowing increasingly accurate targeted solutions therapeutic benefits. For example, it becoming possible to modulate specific nerve fibers, hence targeting diseases. However, fully exploit approach crucial understand what aspects are important, effect stimulation, circuit designs can best achieve desired result. Neuromorphic represent a promising design style achieving goal: their ultra-low power characteristics biologically plausible time constants make them ideal candidate building optimal interfaces real neural processing systems, enabling real-time closed-loop interactions with biological tissue. In paper, we highlight main features neuromorphic that ideally suited interfacing show how they be build hybrid artificial systems. We present examples computational primitives implemented carrying out computation on sensed these systems discuss way use outputs stimulation. describe applications follow approach, open challenges need addressed, propose actions required overcome current limitations.
Language: Английский
Citations
17