Journal articles: 'Neuromodulatory treatments'

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Thomas, G. P., Y. Maeda, and C. J. Vaizey. "Patient Responses to Different Neuromodulatory Treatments." Diseases of the Colon & Rectum 57, no. 2 (February 2014): e18. http://dx.doi.org/10.1097/dcr.0000000000000045.

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Finnegan, Martha, and Declan McLoughlin. "Neurostimulatory, neuromodulatory and neurosurgical treatments in psychiatry." Medicine 44, no. 12 (December 2016): 742–44. http://dx.doi.org/10.1016/j.mpmed.2016.09.009.

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Lynch, Marie, and Declan McLoughlin. "Neurostimulatory, neuromodulatory and neurosurgical treatments in psychiatry." Medicine 48, no. 12 (December 2020): 793–95. http://dx.doi.org/10.1016/j.mpmed.2020.09.010.

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Salib, Anne-Mary, Allen Ho, Eric Sussman, Arjun Pendharkar, and Casey Halpern. "Neuromodulatory Treatments for Alcohol Use Disorder: A Review." Brain Sciences 8, no. 6 (May 28, 2018): 95. http://dx.doi.org/10.3390/brainsci8060095.

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Jensen, Mark P., Melissa A. Day, and Jordi Miró. "Neuromodulatory treatments for chronic pain: efficacy and mechanisms." Nature Reviews Neurology 10, no. 3 (February 18, 2014): 167–78. http://dx.doi.org/10.1038/nrneurol.2014.12.

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Koek, Ralph J., Janine Roach, Nicholas Athanasiou, Mascha van 't Wout-Frank, and Noah S. Philip. "Neuromodulatory treatments for post-traumatic stress disorder (PTSD)." Progress in Neuro-Psychopharmacology and Biological Psychiatry 92 (June 2019): 148–60. http://dx.doi.org/10.1016/j.pnpbp.2019.01.004.

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Miró, Jordi, Elena Castarlenas, Rocío de la Vega, Rubén Roy, Ester Solé, Catarina Tomé-Pires, and Mark Jensen. "Psychological Neuromodulatory Treatments for Young People with Chronic Pain." Children 3, no. 4 (December 6, 2016): 41. http://dx.doi.org/10.3390/children3040041.

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Kilian, Hannah M., Dora M. Meyer, and Thomas E. Schlaepfer. "Putative novel neuromodulatory treatments for affective disorders – What might emerge?" Personalized Medicine in Psychiatry 17-18 (November 2019): 46–50. http://dx.doi.org/10.1016/j.pmip.2019.07.002.

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McGaugh, James L. "Significance and Remembrance: The Role of Neuromodulatory Systems." Psychological Science 1, no. 1 (January 1990): 15–25. http://dx.doi.org/10.1111/j.1467-9280.1990.tb00060.x.

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It is now well known that the retention of newly-acquired information can be modulated by drugs or hormones administered shortly following training. It is generally thought that such treatments influence retention by modifying processes underlying the storage of information. The fact that susceptibility to posttraining memory modulation is seen in many species, including bees, fish, birds, and mammals, argues that some common time-dependent memory storage processes have been conserved in evolution. Recent research findings have provided strong support for the view that such susceptibility to posttraining influences provides opportunity for modulation of memory storage by endogenous neurohormonal systems. In rats and mice, posttraining administration of hormones such as epinephrine that are normally released by training experiences enhances subsequent retention. Comparable effects are found with posttraining administration of opiate receptor antagonists such as naloxone. Findings of recent experiments indicate that these treatments affect memory by influencing the release of norepinephrine within the amygdaloid complex. The endogenous regulation of memory storage appears to involve interaction of neurohormones and transmitters in activating brain systems involved in memory storage.

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May, Arne, and Peter J. Goadsby. "Neuromodulatory Approaches to the Management of Medically Refractory Cluster Headache." US Neurology 06, no. 02 (2010): 125. http://dx.doi.org/10.17925/usn.2010.06.02.125.

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The trigeminal autonomic cephalalgias are a group of primary headache disorders characterized by unilateral trigeminal distribution of pain that occurs in association with ipsilateral cranial autonomic features. The most prominent one is cluster headache, a dreadful disease with excrutiating pain attacks. These attacks last no longer than two hours but may occur several times per day. It is mandatory to find an efficient therapy for these patients, but some are unresponsive to all treatments. In these intractable cases invasive procedures are introduced, but the available evidence (while conflicting) illustrates that trigeminal denervation may not be effective in preventing the headache attacks or autonomic symptoms of chronic cluster headache. Modern neurostimulating approaches, such as stimulation of the greater occipital nerve and hypothalamic deep brain stimulation, supersede neurodestructive procedures. Both stimulation methods are exquisite and potentially life-saving treatment options in otherwise intractable patients, but they need to be better characterized and further long-term data are needed.

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May, Arne, and Peter J. Goadsby. "Neuromodulatory Approaches to the Management of Medically Refractory Cluster Headache." European Neurological Review 5, no. 1 (2010): 97. http://dx.doi.org/10.17925/enr.2010.05.01.97.

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The trigeminal autonomic cephalalgias are a group of primary headache disorders characterised by unilateral trigeminal distribution of pain that occurs in association with ipsilateral cranial autonomic features. The most prominent one is cluster headache, a dreadful disease with excrutiating pain attacks. These attacks last no longer than two hours but may occur several times per day. It is mandatory to find an efficient therapy for these patients, but some are unresponsive to all treatments. In these intractable cases invasive procedures are introduced, but the available evidence (while conflicting) illustrates that trigeminal denervation may not be effective in preventing the headache attacks or autonomic symptoms of chronic cluster headache. Modern neurostimulating approaches, such as stimulation of the greater occipital nerve and hypothalamic deep brain stimulation, supersede neurodestructive procedures. Both stimulation methods are exquisite and potentially lifesaving treatment options in otherwise intractable patients, but they need to be better characterised and further long-term data are needed.

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Zugliani, Morena M., Mariana C. Cabo, Antonio E. Nardi, Giampaolo Perna, and Rafael C. Freire. "Pharmacological and Neuromodulatory Treatments for Panic Disorder: Clinical Trials from 2010 to 2018." Psychiatry Investigation 16, no. 1 (January 25, 2019): 50–58. http://dx.doi.org/10.30773/pi.2018.12.21.1.

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Elias, Gavin J. B., Alexandre Boutet, Roohie Parmar, Emily H. Y. Wong, Jürgen Germann, Aaron Loh, Michelle Paff, et al. "Neuromodulatory treatments for psychiatric disease: A comprehensive survey of the clinical trial landscape." Brain Stimulation 14, no. 5 (September 2021): 1393–403. http://dx.doi.org/10.1016/j.brs.2021.08.021.

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Davis, Lauren E., and Evelyn Attia. "Recent advances in therapies for eating disorders." F1000Research 8 (September 26, 2019): 1693. http://dx.doi.org/10.12688/f1000research.19847.1.

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Eating disorders are serious psychiatric illnesses with high rates of morbidity and mortality. Effective treatments have traditionally included behaviorally focused therapies as well as several medication strategies. Recent years have seen promising developments in these treatments, including additional support for family-based approaches for children and adolescents, new evidence for “third-wave” behavioral therapies, and new support for the use of lisdexamfetamine for binge eating disorder and olanzapine for anorexia nervosa. Case study and pilot data are beginning to show limited support for neuromodulatory interventions targeting brain regions thought to be involved in eating disorders. This review summarizes treatment developments over the last several years and points towards future directions for the field.

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van den Brink, W. "Treatment Innovations of Opiate Dependence Treatment." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70252-4.

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Opiate dependence is a serious psychiatric disorder with substantial suffering for the patient, his environment and society as a whole. Currently available treatments include abstinence oriented treatment with naltrexone and substitutian treatments with methadone and buprenorphine. However, treatment compliance with naltrexone is very low resulting in low effectiveness. In addition, existing substituation treatments only show moderate effectiveness resulting in a large number of patients showing continued drug use and serious psychological, somatic and functional impairment.New treatment strategies involve:a.the development of long acting opiate antagonists (naltrexone) and partial agonist (buprenorphine) to improve treatment compliance and treatment retention,b.new substitution options such as slow release oral morphine (SROM), oral diacetylmorphine (heroin) and inhalable and injectable diacetyl morphine (heroin assisted treatment: HAT).Recently, a new approach using neurosurgical and neuromodulatory techniques has been advocated to help treatment refractory opiate dependent patients. Finally, certain combinations of farmacotherapy and psychosocial interventions have shown promise for future improvements.This presentation reviews the evidence of existing treatments for opiate dependence and explores the new treatment options for patients not fully responsive to the existing treatment modalities.

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Ferrier, I. Nicol, Jonathan Waite, and Vimal Sivasanker. "Recent advances in electroconvulsive therapy and physical treatments for depression." BJPsych Advances 27, no. 5 (March 9, 2021): 295–302. http://dx.doi.org/10.1192/bja.2021.18.

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SUMMARYThis article gives an update for practitioners on recent developments in the use of electroconvulsive therapy (ECT) and related treatment modalities in the contemporary treatment of depression in the UK. Details are provided on new information on the efficacy and side-effects of ECT both in research studies and in the real world, together with recent research on ECT's mode of delivery. There is a focus on the safe administration of ECT in clinical practice. An update on the regulatory framework for ECT in the UK is provided, together with up-to-date information on the legal situation regarding its prescription. Finally, brief summaries of the current position for other neuromodulatory treatment modalities are given.

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Leung, Michael Min Wah. "Shocking the brain to regain motor function : a non-invasive therapy for stroke patients." University of Ottawa Science Undergraduate Research Journal 1 (August 23, 2018): 20–22. http://dx.doi.org/10.18192/osurj.v1i1.3681.

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Invasive treatments and its associated risks are important factors of concern when the conditions are affecting the nervous system. Transcranial direct current stimulation (tDCS) is a non-invasive technique that stimulates brain areas through the scalp and has excitatory or inhibitory neuromodulatory effects. In the context of stroke patients, recovery is often impaired from the increased inhibition of the damaged area from the unaffected hemisphere. Fujimoto et al. uses dual-hemisphere transcranial direct current stimulation to address this interhemispheric inhibition and demonstrates that stroke patients were able to periodically restore sensory deficits.

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Zhao, Ning, Hong Zhang, Tongyan Liu, Jiao Liu, Yun Xiang, Guojian Shu, Chunzhen Li, Jingwen Xie, and Lidian Chen. "Neuromodulatory Effect of Sensorimotor Network Functional Connectivity of Temporal Three-Needle Therapy for Ischemic Stroke Patients with Motor Dysfunction: Study Protocol for a Randomized, Patient-Assessor Blind, Controlled, Neuroimaging Trial." Evidence-Based Complementary and Alternative Medicine 2021 (January 4, 2021): 1–11. http://dx.doi.org/10.1155/2021/8820324.

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Background. The clinical efficacy of temporal three-needle therapy for stroke dysfunction has been previously demonstrated in China. However, the central mechanism of temporal three-needle therapy remains unclear. Temporal three-needle projects the sensory cortex and the motor cortex, which may impact the cortex function. Current studies seldom focus on it. Hence, according to the “scalp-cortex corresponding theory,” the underlying mechanism of temporal three-needle remains a domain for further research. Methods. This trial is designed to provide objective and visual evidence for the neuromodulatory effect and neuroimaging mechanism of temporal three-needle therapy for stroke patients. This ongoing study is a prospective, randomized, controlled, patient-assessor blind, single-center, neuroimaging trial involving two-parallel patient groups and a healthy control group. Forty eligible patients will be recruited from Shenzhen Nanshan District People’s Hospital and randomized into either the experimental group or the control group. Twenty healthy volunteers will be recruited in the healthy control group and undergo baseline magnetic resonance imaging scans without any intervention. Patients in the control group will receive acupuncture at Dingnieqianxiexian (MS6), in addition to basic medicine and rehabilitative treatments. Patients in the experimental group will receive temporal three-needle therapy plus basic medicine and rehabilitative treatments 5 days per week, 10 sessions over two consecutive weeks. The primary outcome is resting-state functional connectivity, and the secondary outcomes are regional homogeneity, amplitude of low-frequency fluctuations, Fugl–Meyer assessment of the upper limb, and modified Barthel Index. All outcome measures will be assessed at baseline and after 2 weeks of intervention. Discussion. The results will explore the neuromodulatory effects and illustrate the central mechanism of temporal three-needle treatment from the network-level viewpoint of sensorimotor network functional plasticity and promote widespread application in real-world practice. This trial was registered at Chinese Clinical Trial Registry on 14 March 2018 with ChiCTR1800015209.

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Smit, Jasper V., Bart J. Pielkenrood, Remo A. G. J. Arts, Miranda L. Janssen, Yasin Temel, and Robert J. Stokroos. "Patient Acceptance of Invasive Treatments for Tinnitus." American Journal of Audiology 27, no. 2 (June 8, 2018): 184–96. http://dx.doi.org/10.1044/2017_aja-17-0015.

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Purpose The field of neuromodulation is currently seeking to treat a wide range of disorders with various types of invasive devices. In recent years, several preclinical trials and case reports in humans have been published on their potential for chronic tinnitus. However, studies to obtain insight into patients' willingness to undergo these treatments are scarce. The aim of this survey study was to find out whether tinnitus patients are willing to undergo invasive neuromodulation when taking its risks, costs, and potential benefits into account. Method A Visual Analog Scale (VAS, 0–10) was used to measure the outcome. Spearman's rank-order correlation coefficients were computed to determine the correlation between patient characteristics and acceptance rates. Results Around one fifth of the patients were reasonably willing to undergo invasive treatment (VAS 5–7), and around one fifth were fully willing to do so (VAS 8–10). Hearing aids, used as a control, were accepted most, followed by cochlear implantation, deep brain stimulation, and cortical stimulation. Acceptance rates were slightly higher when the chance of cure was higher. Patients with a history of attempted treatments were more eager than others to find a new treatment for tinnitus. Conclusions A considerable proportion of patients with tinnitus would accept a variety of invasive treatments despite the associated risks or costs. When clinical neuromodulatory studies for tinnitus are to be performed, particular attention should be given to obtaining informed consent, including explaining the potential risks and providing a realistic outcome expectation.

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Heijmans, Lonne, Martijn R. Mons, and Elbert A. Joosten. "A systematic review on descending serotonergic projections and modulation of spinal nociception in chronic neuropathic pain and after spinal cord stimulation." Molecular Pain 17 (January 2021): 174480692110439. http://dx.doi.org/10.1177/17448069211043965.

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Chronic neuropathic pain is a debilitating ordeal for patients worldwide and pharmacological treatment efficacy is still limited. As many pharmacological interventions for neuropathic pain often fail, insights into the underlying mechanism and role of identified receptors is of utmost importance. An important target for improving treatment of neuropathic pain is the descending serotonergic system as these projections modulate nociceptive signaling in the dorsal horn. Also with use of last resort treatments like spinal cord stimulation (SCS), the descending serotonergic projections are known to be involved in the pain relieving effect. This systematic review summarizes the involvement of the serotonergic system on nociceptive modulation in the healthy adult rodent and the chronic neuropathic rodent and summarizes all available literature on the serotonergic system in the SCS-treated neuropathic rodent. Medline, Embase and Pubmed databases were used in the search for articles. Descending serotonergic modulation of nociceptive signaling in spinal dorsal horn in normal adult rat is mainly inhibitory and mediated by 5-HT1a, 5-HT1b, 5-HT2c, 5-HT3 and 5-HT4 receptors. Upon injury and in the neuropathic rat, this descending serotonergic modulation becomes facilitatory via activation of the 5-HT2a, 5-HT2b and 5-HT3 receptors. Analgesia due to neuromodulatory intervention like SCS restores the inhibitory function of the descending serotonergic system and involves 5-HT2, 5-HT3 and 5-HT4 receptors. The results of this systematic review provide insights and suggestions for further pharmacological and or neuromodulatory treatment of neuropathic pain based on targeting selected serotonergic receptors related to descending modulation of nociceptive signaling in spinal dorsal horn. With the novel developed SCS paradigms, the descending serotonergic system will be an important target for mechanism-based stimulation induced analgesia.

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Weickhardt, Andrew, Keith Wells, and Wells Messersmith. "Oxaliplatin-Induced Neuropathy in Colorectal Cancer." Journal of Oncology 2011 (2011): 1–7. http://dx.doi.org/10.1155/2011/201593.

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Oxaliplatin use in palliative and adjuvant treatment of colon cancer is frequently limited by cumulative neurotoxicity, leading to reduced quality of life and decreased dose. The mechanism of this neurotoxicity is unclear, but may relate to neuronal voltage-gated sodium channels involving calcium chelation by a metabolite of the drug. Various preventative measures have been tested to reduce the incidence of neurotoxicity, including calcium and magnesium infusions, dose interruption of the drug, and prophylactic neuromodulatory agents. Despite the promising efficacy of these measures, they are not universally accepted. Less is known about the best way to treat established neurotoxicity, which is permanent in some patients, although venlafaxine has shown promise in small clinical trials. This paper analyzes the extent, cause and risk factors for neuropathy, and the potential preventative and therapeutic treatments for oxaliplatin-induced neuropathy.

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Cunliffe, Grace, Yi Tang Lim, Woori Chae, and Sangyong Jung. "Alternative Pharmacological Strategies for the Treatment of Alzheimer’s Disease: Focus on Neuromodulator Function." Biomedicines 10, no. 12 (November 28, 2022): 3064. http://dx.doi.org/10.3390/biomedicines10123064.

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Alzheimer’s disease (AD) is a neurodegenerative disorder, comprising 70% of dementia diagnoses worldwide and affecting 1 in 9 people over the age of 65. However, the majority of its treatments, which predominantly target the cholinergic system, remain insufficient at reversing pathology and act simply to slow the inevitable progression of the disease. The most recent neurotransmitter-targeting drug for AD was approved in 2003, strongly suggesting that targeting neurotransmitter systems alone is unlikely to be sufficient, and that research into alternate treatment avenues is urgently required. Neuromodulators are substances released by neurons which influence neurotransmitter release and signal transmission across synapses. Neuromodulators including neuropeptides, hormones, neurotrophins, ATP and metal ions display altered function in AD, which underlies aberrant neuronal activity and pathology. However, research into how the manipulation of neuromodulators may be useful in the treatment of AD is relatively understudied. Combining neuromodulator targeting with more novel methods of drug delivery, such as the use of multi-targeted directed ligands, combinatorial drugs and encapsulated nanoparticle delivery systems, may help to overcome limitations of conventional treatments. These include difficulty crossing the blood-brain-barrier and the exertion of effects on a single target only. This review aims to highlight the ways in which neuromodulator functions are altered in AD and investigate how future therapies targeting such substances, which act upstream to classical neurotransmitter systems, may be of potential therapeutic benefit in the sustained search for more effective treatments.

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De Gandarias, Juan M., Enrique Echevarria, Roberto Serrano, Jon Irazusta, and Luis Casis. "Effect of Subacute Toluene Administration on the Enkephalinergic Neuromodulatory System in Rats and Protective Action of Ganglioside Treatments." Toxicology and Industrial Health 10, no. 3 (May 1994): 155–61. http://dx.doi.org/10.1177/074823379401000305.

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Gangliosides perform protective functions in the central nervous system. This paper describes a study of the effect of ganglioside administration on toluene neurotoxicity. Rat brain met-enkephalin immunostaining in the central amygdaloid nuclei showed changes in rats treated simultaneously with gangliosides and toluene with respect to rats treated with toluene alone. It is suggested that gangliosides prevent toluene neurotoxicity at this level, leading to hypothetical neurobehavioral changes.

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Shindou, Tomomi, Gordon W. Arbuthnott, and Jeffery R. Wickens. "Actions of Adenosine A2A Receptors on Synaptic Connections of Spiny Projection Neurons in the Neostriatal Inhibitory Network." Journal of Neurophysiology 99, no. 4 (April 2008): 1884–89. http://dx.doi.org/10.1152/jn.01259.2007.

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There is growing evidence that adenosine plays a crucial role in basal ganglia function, particularly in the modulation of voluntary movement. An adenosine-based treatment for Parkinson's disease shows promise in recent clinical studies. Adenosine A2A receptors, the receptors involved in this treatment, are highly expressed in the neostriatum. Previous studies have suggested opposing actions of these receptors on synaptic transmission at striatal and pallidal terminals of the same spiny projection neurons, but the cells of origin of the intrastriatal terminals mediating these actions have not been identified. We used dual whole cell recordings to record simultaneously from pairs of striatal cells; this enabled definitive identification of the presynaptic and postsynaptic cells mediating the effects of A2A receptors. We found that A2A receptors facilitate GABAergic synaptic transmission by intrastriatal collaterals of the spiny projection neurons, consistent with their previously reported actions on synaptic transmission at pallidal terminals. This neuromodulatory action on lateral inhibition in the striatum may underlie, in part, the therapeutic efficacy of adenosine-based treatments for Parkinson's disease.

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Nardone, Raffaele, Jürgen Bergmann, Monica Christova, Francesca Caleri, Frediano Tezzon, Gunther Ladurner, Eugen Trinka, and Stefan Golaszewski. "Effect of Transcranial Brain Stimulation for the Treatment of Alzheimer Disease: A Review." International Journal of Alzheimer's Disease 2012 (2012): 1–5. http://dx.doi.org/10.1155/2012/687909.

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Available pharmacological treatments for Alzheimer disease (AD) have limited effectiveness, are expensive, and sometimes induce side effects. Therefore, alternative or complementary adjuvant therapeutic strategies have gained increasing attention. The development of novel noninvasive methods of brain stimulation has increased the interest in neuromodulatory techniques as potential therapeutic tool for cognitive rehabilitation in AD. In particular, repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are noninvasive approaches that induce prolonged functional changes in the cerebral cortex. Several studies have begun to therapeutically use rTMS or tDCS to improve cognitive performances in patients with AD. However, most of them induced short-duration beneficial effects and were not adequately powered to establish evidence for therapeutic efficacy. Therefore, TMS and tDCS approaches, seeking to enhance cognitive function, have to be considered still very preliminary. In future studies, multiple rTMS or tDCS sessions might also interact, and metaplasticity effects could affect the outcome.

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Hotouras, Alexander, Jamie Murphy, Marion Allison, Anne Curry, Norman S. Williams, Charles H. Knowles, and Christopher L. Chan. "Prospective clinical audit of two neuromodulatory treatments for fecal incontinence: sacral nerve stimulation (SNS) and percutaneous tibial nerve stimulation (PTNS)." Surgery Today 44, no. 11 (May 5, 2014): 2124–30. http://dx.doi.org/10.1007/s00595-014-0898-0.

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Sasegbon, Ayodele, Ulrike Hammerbeck, Emilia Michou, Ivy Cheng, Mengqing Zhang, Charlotte James, and Shaheen Hamdy. "A feasibility pilot study of the effects of neurostimulation on swallowing function in Parkinson’s Disease." AMRC Open Research 3 (April 8, 2022): 19. http://dx.doi.org/10.12688/amrcopenres.13007.2.

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Introduction: Dysphagia often occurs during Parkinson’s disease (PD) and can have severe consequences. Recently, neuromodulatory techniques have been used to treat neurogenic dysphagia. Here we aimed to compare the neurophysiological and swallowing effects of three different types of neurostimulation, 5 Hertz (Hz) repetitive transcranial magnetic stimulation (rTMS), 1 Hz rTMS and pharyngeal electrical stimulation (PES) in patients with PD. Method: 12 PD patients with dysphagia were randomised to receive either 5 Hz rTMS, 1 Hz rTMS, or PES. In a cross-over design, patients were assigned to one intervention and received both real and sham stimulation. Patients received a baseline videofluoroscopic (VFS) assessment of their swallowing, enabling penetration aspiration scores (PAS) to be calculated for: thin fluids, paste, solids and cup drinking. Swallowing timing measurements were also performed on thin fluid swallows only. They then had baseline recordings of motor evoked potentials (MEPs) from both pharyngeal and (as a control) abductor pollicis brevis (APB) cortical areas using single-pulse TMS. Subsequently, the intervention was administered and post interventional TMS recordings were taken at 0 and 30 minutes followed by a repeat VFS within 60 minutes of intervention. Results: All interventions were well tolerated. Due to lower than expected recruitment, statistical analysis of the data was not undertaken. However, with respect to PAS swallowing timings and MEP amplitudes, there was small but visible difference in the outcomes between active and sham. Conclusion: PES, 5 Hz rTMS and 1 Hz rTMS are tolerable interventions in PD related dysphagia. Due to small patient numbers no definitive conclusions could be drawn from the data with respect to individual interventions improving swallowing function and comparative effectiveness between interventions. Larger future studies are needed to further explore the efficacy of these neuromodulatory treatments in Parkinson’s Disease associated dysphagia.

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Sasegbon, Ayodele, Ulrike Hammerbeck, Emilia Michou, Ivy Cheng, Mengqing Zhang, Charlotte James, and Shaheen Hamdy. "A feasibility pilot study of the effects of neurostimulation on dysphagia recovery in Parkinson’s Disease." AMRC Open Research 3 (September 1, 2021): 19. http://dx.doi.org/10.12688/amrcopenres.13007.1.

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Introduction: Dysphagia often occurs during Parkinson’s disease (PD) and can have severe consequences. Recently, neuromodulatory techniques have been used to treat neurogenic dysphagia. Here we aimed to compare the neurophysiological and swallowing effects of three different types of neurostimulation, 5 Hertz (Hz) repetitive transcranial magnetic stimulation (rTMS), 1 Hz rTMS and pharyngeal electrical stimulation (PES). Method: 12 PD patients with dysphagia were randomised to receive either 5 Hz rTMS, 1 Hz rTMS, or PES. In a cross-over design, patients were assigned to one intervention and received both real and sham stimulation. Patients received a baseline videofluoroscopic (VFS) assessment of their swallowing, enabling penetration aspiration scores (PAs) to be calculated for: thin fluids, paste, solids and cup drinking. Swallowing timing measurements were also performed on thin fluid swallows only. They then had baseline recordings of motor evoked potentials (MEPs) from both pharyngeal and (as a control) abductor pollicis brevis (APB) cortical areas using single-pulse TMS. Subsequently, the intervention was administered and post interventional TMS recordings were taken at 0 and 30 minutes followed by a repeat VFS within 60 minutes of intervention. Results: All interventions were well tolerated. Due to lower than expected recruitment, statistical analysis of the data was not undertaken. However, with respect to PAs swallowing timings and MEP amplitudes, there was visual separation in a positive direction between active and sham groups for all interventions. Conclusion: PES, 5 Hz rTMS and 1 Hz rTMS are tolerable interventions in PD related dysphagia. Due to small patient numbers no definitive conclusions could be drawn from the data with respect to individual interventions improving swallowing function and comparative effectiveness between interventions. Larger future studies are needed to further explore the efficacy of these neuromodulatory treatments in Parkinson’s Disease associated dysphagia.

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Bonakdarpour, Borna. "Neuroimaging in Primary Progressive Aphasia." Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders 24, no. 4 (October 2014): 145–56. http://dx.doi.org/10.1044/nnsld24.4.145.

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Neuroimaging is a standard part of a primary progressive aphasia (PPA) diagnostic work-up and an important component of research investigating changes in the speech-language network in patients with PPA. In this paper, structural neuroimaging, including computed tomography (CT), magnetic resonance imaging (MRI), and diffusion tensor imaging (DTI), as well as functional neuroimaging, including single photon emission computed tomography (SPECT), positron emission tomography (PET), and functional MRI (fMRI), are discussed. Neuroimaging, in conjunction with meticulous clinical and neuropsychological evaluation, can increase diagnostic certainty for PPA subtyping and identification of underlying pathology, which is important for justification of potential pharmacological treatments, such as cholinesterase inhibitors. MRI and, more recently, DTI, have expanded our knowledge of structural brain changes in PPA, including gray matter abnormalities as well as alterations in neuronal tracts. SPECT and PET provide information regarding brain regional blood perfusion (SPECT) or metabolism (PET). Recently, thanks to PET ligands that bind to amyloid protein, it has become possible to diagnose or rule out Alzheimer pathology as a cause for PPA and tau imaging may be forthcoming. Finally, fMRI provides a unique window into brain-behavior relations for language as well as reorganization of the language network in disease. fMRI has also been used to gauge the effects of therapeutic interventions, including language treatment, and can be used for implementation of neuromodulatory mediations, such as repetitive transcranial magnetic stimulation (TMS).

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Hoptman, Matthew J. "Impulsivity and aggression in schizophrenia: a neural circuitry perspective with implications for treatment." CNS Spectrums 20, no. 3 (April 22, 2015): 280–86. http://dx.doi.org/10.1017/s1092852915000206.

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Elevations of impulsive behavior have been observed in a number of serious mental illnesses. These phenomena can lead to harmful behaviors, including violence, and thus represent a serious public health concern. Such violence is often a reason for psychiatric hospitalization, and it often leads to prolonged hospital stays, suffering by patients and their victims, and increased stigmatization. Despite the attention paid to violence, little is understood about its neural basis in schizophrenia. On a psychological level, aggression in schizophrenia has been primarily attributed to psychotic symptoms, desires for instrumental gain, or impulsive responses to perceived personal slights. Often, multiple attributions can coexist during a single aggressive incident. In this review, I discuss the neural circuitry associated with impulsivity and aggression in schizophrenia, with an emphasis on implications for treatment. Impulsivity appears to account for a great deal of aggression in schizophrenia, especially in inpatient settings. Urgency, defined as impulsivity in the context of strong emotion, is the primary focus of this article. It is elevated in several psychiatric disorders, and in schizophrenia, it has been related to aggression. Many studies have implicated dysfunctional frontotemporal circuitry in impulsivity and aggression in schizophrenia, and pharmacological treatments may act via that circuitry to reduce urgency and aggressive behaviors; however, more mechanistic studies are critically needed. Recent studies point toward manipulable neurobehavioral targets and suggest that cognitive, pharmacological, neuromodulatory, and neurofeedback treatment approaches can be developed to ameliorate urgency and aggression in schizophrenia. It is hoped that these approaches will improve treatment efficacy.

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McGovern, Robert A., and Sameer A. Sheth. "Role of the dorsal anterior cingulate cortex in obsessive-compulsive disorder: converging evidence from cognitive neuroscience and psychiatric neurosurgery." Journal of Neurosurgery 126, no. 1 (January 2017): 132–47. http://dx.doi.org/10.3171/2016.1.jns15601.

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OBJECTIVE Advances in understanding the neurobiological basis of psychiatric disorders will improve the ability to refine neuromodulatory procedures for treatment-refractory patients. One of the core dysfunctions in obsessive-compulsive disorder (OCD) is a deficit in cognitive control, especially involving the dorsal anterior cingulate cortex (dACC). The authors' aim was to derive a neurobiological understanding of the successful treatment of refractory OCD with psychiatric neurosurgical procedures targeting the dACC. METHODS First, the authors systematically conducted a review of the literature on the role of the dACC in OCD by using the search terms “obsessive compulsive disorder” and “anterior cingulate.” The neuroscience literature on cognitive control mechanisms in the dACC was then combined with the literature on psychiatric neurosurgical procedures targeting the dACC for the treatment of refractory OCD. RESULTS The authors reviewed 89 studies covering topics that included structural and functional neuroimaging and electrophysiology. The majority of resting-state functional neuroimaging studies demonstrated dACC hyperactivity in patients with OCD relative to that in controls, while task-based studies were more variable. Electrophysiological studies showed altered dACC-related biomarkers of cognitive control, such as error-related negativity in OCD patients. These studies were combined with the cognitive control neurophysiology literature, including the recently elaborated expected value of control theory of dACC function. The authors suggest that a central feature of OCD pathophysiology involves the generation of mis-specified cognitive control signals by the dACC, and they elaborate on this theory and provide suggestions for further study. CONCLUSIONS Although abnormalities in brain structure and function in OCD are distributed across a wide network, the dACC plays a central role. The authors propose a theory of cognitive control dysfunction in OCD that attempts to explain the therapeutic efficacy of dACC neuromodulation. This theoretical framework should help to guide further research into targeted treatments of OCD and other disorders of cognitive control.

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Honig, Gerard, Paul B. Larkin, Caren Heller, and Andrés Hurtado-Lorenzo. "Research-Based Product Innovation to Address Critical Unmet Needs of Patients with Inflammatory Bowel Diseases." Inflammatory Bowel Diseases 27, Supplement_2 (November 15, 2021): S1—S16. http://dx.doi.org/10.1093/ibd/izab230.

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Abstract Despite progress in recent decades, patients with inflammatory bowel diseases face many critical unmet needs, demonstrating the limitations of available treatment options. Addressing these unmet needs will require interventions targeting multiple aspects of inflammatory bowel disease pathology, including disease drivers that are not targeted by available therapies. The vast majority of late-stage investigational therapies also focus primarily on a narrow range of fundamental mechanisms. Thus, there is a pressing need to advance to clinical stage differentiated investigational therapies directly targeting a broader range of key mechanistic drivers of inflammatory bowel diseases. In addition, innovations are critically needed to enable treatments to be tailored to the specific underlying abnormal biological pathways of patients; interventions with improved safety profiles; biomarkers to develop prognostic, predictive, and monitoring tests; novel devices for nonpharmacological approaches such as minimally invasive monitoring; and digital health technologies. To address these needs, the Crohn’s & Colitis Foundation launched IBD Ventures, a venture philanthropy–funding mechanism, and IBD Innovate®, an innovative, product-focused scientific conference. This special IBD Innovate® supplement is a collection of articles reflecting the diverse and exciting research and development that is currently ongoing in the inflammatory bowel disease field to deliver innovative and differentiated products addressing critical unmet needs of patients. Here, we highlight the pipeline of new product opportunities currently advancing at the preclinical and early clinical development stages. We categorize and describe novel and differentiated potential product opportunities based on their potential to address the following critical unmet patient needs: (1) biomarkers for prognosis of disease course and prediction/monitoring of treatment response; (2) restoration of eubiosis; (3) restoration of barrier function and mucosal healing; (4) more effective and safer anti-inflammatories; (5) neuromodulatory and behavioral therapies; (6) management of disease complications; and (7) targeted drug delivery.

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Cantone, Mariagiovanna, Giuseppe Lanza, Francesco Fisicaro, Manuela Pennisi, Rita Bella, Vincenzo Di Lazzaro, and Giovanni Di Pino. "Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation." Neural Plasticity 2020 (October 27, 2020): 1–17. http://dx.doi.org/10.1155/2020/8820881.

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The exact relationship between cognitive functioning, cortical excitability, and synaptic plasticity in dementia is not completely understood. Vascular cognitive impairment (VCI) is deemed to be the most common cognitive disorder in the elderly since it encompasses any degree of vascular-based cognitive decline. In different cognitive disorders, including VCI, transcranial magnetic stimulation (TMS) can be exploited as a noninvasive tool able to evaluate in vivo the cortical excitability, the propension to undergo neural plastic phenomena, and the underlying transmission pathways. Overall, TMS in VCI revealed enhanced cortical excitability and synaptic plasticity that seem to correlate with the disease process and progression. In some patients, such plasticity may be considered as an adaptive response to disease progression, thus allowing the preservation of motor programming and execution. Recent findings also point out the possibility to employ TMS to predict cognitive deterioration in the so-called “brains at risk” for dementia, which may be those patients who benefit more of disease-modifying drugs and rehabilitative or neuromodulatory approaches, such as those based on repetitive TMS (rTMS). Finally, TMS can be exploited to select the responders to specific drugs in the attempt to maximize the response and to restore maladaptive plasticity. While no single TMS index owns enough specificity, a panel of TMS-derived measures can support VCI diagnosis and identify early markers of progression into dementia. This work reviews all TMS and rTMS studies on VCI. The aim is to evaluate how cortical excitability, plasticity, and connectivity interact in the pathophysiology of the impairment and to provide a translational perspective towards novel treatments of these patients. Current pitfalls and limitations of both studies and techniques are also discussed, together with possible solutions and future research agenda.

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Reis de Assis, Denis, Attila Szabo, Jordi Requena Osete, Francesca Puppo, Kevin S. O’Connell, Ibrahim A. Akkouh, Timothy Hughes, Evgeniia Frei, Ole A. Andreassen, and Srdjan Djurovic. "Using iPSC Models to Understand the Role of Estrogen in Neuron–Glia Interactions in Schizophrenia and Bipolar Disorder." Cells 10, no. 2 (January 21, 2021): 209. http://dx.doi.org/10.3390/cells10020209.

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Schizophrenia (SCZ) and bipolar disorder (BIP) are severe mental disorders with a considerable disease burden worldwide due to early age of onset, chronicity, and lack of efficient treatments or prevention strategies. Whilst our current knowledge is that SCZ and BIP are highly heritable and share common pathophysiological mechanisms associated with cellular signaling, neurotransmission, energy metabolism, and neuroinflammation, the development of novel therapies has been hampered by the unavailability of appropriate models to identify novel targetable pathomechanisms. Recent data suggest that neuron–glia interactions are disturbed in SCZ and BIP, and are modulated by estrogen (E2). However, most of the knowledge we have so far on the neuromodulatory effects of E2 came from studies on animal models and human cell lines, and may not accurately reflect many processes occurring exclusively in the human brain. Thus, here we highlight the advantages of using induced pluripotent stem cell (iPSC) models to revisit studies of mechanisms underlying beneficial effects of E2 in human brain cells. A better understanding of these mechanisms opens the opportunity to identify putative targets of novel therapeutic agents for SCZ and BIP. In this review, we first summarize the literature on the molecular mechanisms involved in SCZ and BIP pathology and the beneficial effects of E2 on neuron–glia interactions. Then, we briefly present the most recent developments in the iPSC field, emphasizing the potential of using patient-derived iPSCs as more relevant models to study the effects of E2 on neuron–glia interactions.

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Bari, Ausaf A., Charles B. Mikell, Aviva Abosch, Sharona Ben-Haim, Robert J. Buchanan, Allen W. Burton, Stephen Carcieri, et al. "Charting the road forward in psychiatric neurosurgery: proceedings of the 2016 American Society for Stereotactic and Functional Neurosurgery workshop on neuromodulation for psychiatric disorders." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 8 (January 25, 2018): 886–96. http://dx.doi.org/10.1136/jnnp-2017-317082.

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ObjectiveRefractory psychiatric disease is a major cause of morbidity and mortality worldwide, and there is a great need for new treatments. In the last decade, investigators piloted novel deep brain stimulation (DBS)-based therapies for depression and obsessive–compulsive disorder (OCD). Results from recent pivotal trials of these therapies, however, did not demonstrate the degree of efficacy expected from previous smaller trials. To discuss next steps, neurosurgeons, neurologists, psychiatrists and representatives from industry convened a workshop sponsored by the American Society for Stereotactic and Functional Neurosurgery in Chicago, Illinois, in June of 2016.DesignHere we summarise the proceedings of the workshop. Participants discussed a number of issues of importance to the community. First, we discussed how to interpret results from the recent pivotal trials of DBS for OCD and depression. We then reviewed what can be learnt from lesions and closed-loop neurostimulation. Subsequently, representatives from the National Institutes of Health, the Food and Drug Administration and industry discussed their views on neuromodulation for psychiatric disorders. In particular, these third parties discussed their criteria for moving forward with new trials. Finally, we discussed the best way of confirming safety and efficacy of these therapies, including registries and clinical trial design. We close by discussing next steps in the journey to new neuromodulatory therapies for these devastating illnesses.ConclusionInterest and motivation remain strong for deep brain stimulation for psychiatric disease. Progress will require coordinated efforts by all stakeholders.

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Hosseini, Mersedeh Bahr, and Jeffrey L. Saver. "Mechanisms of action of acute and subacute sphenopalatine ganglion stimulation for ischemic stroke." International Journal of Stroke 15, no. 8 (April 23, 2020): 839–48. http://dx.doi.org/10.1177/1747493020920739.

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Background Sphenopalatine ganglion stimulation (SPG-Stim) for ischemic stroke, starting 8–24 h after onset and continuing through five days in a pooled analysis of two recent, randomized, sham-controlled trials, improved outcome of acute ischemic stroke patients with confirmed cortical involvement. As a neuromodulatory therapy, SPG-Stim differs substantially from existing pharmacologic (lytic and antiplatelets) and device (endovascular thrombectomy) acute ischemic stroke treatments. Aim Focused review of SPG anatomy, physiology, and neurovascular and neurobiologic mechanisms of action mediating benefit of SPG-Stim in acute ischemic stroke. Summary of review Located posterior to the maxillary sinus, the SPG is the main source of parasympathetic innervation to the anterior circulation. Preclinical and human studies delineate four distinct mechanisms of action by which the SPG-Stim may confer benefit in acute ischemic stroke: (1) collateral vasodilation and enhanced cerebral blood flow, mediated by release of neurotransmitters with vasodilatory effects, nitric oxide, and acetylcholine, (2) stimulation frequency- and intensity-dependent stabilization of the blood–brain barrier, reducing edema (3) direct acute neuroprotection from activation of the central cholinergic system with resulting anti-inflammatory, anti-apoptotic, and anti-excitatory effects; and (4) neuroplasticity enhancement from enhanced central cholinergic and adrenergic neuromodulation of cortical networks and nitrous oxide release stimulating neurogenesis. Conclusion The benefit of SPG-Stim in acute ischemic stroke is likely conferred not only by potent collateral augmentation, but also blood–barrier stabilization, direct neuroprotection, and neuroplasticity enhancement. Further studies clarifying the relative contribution of these mechanisms and the stimulation protocols that maximize each may help optimize SPG-Stim as a therapy for acute ischemic stroke.

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Vega-García, Angelica, Teresa Neri-Gómez, Vinnitsa Buzoianu-Anguiano, Christian Guerra-Araiza, Julia Segura-Uribe, Iris Feria-Romero, and Sandra Orozco-Suarez. "Electroacupuncture Reduces Seizure Activity and Enhances GAD 67 and Glutamate Transporter Expression in Kainic Acid Induced Status Epilepticus in Infant Rats." Behavioral Sciences 9, no. 7 (June 27, 2019): 68. http://dx.doi.org/10.3390/bs9070068.

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Status epilepticus (SE) is one of the most significant complications in pediatric neurology. Clinical studies have shown positive effects of electroacupuncture (EA) as a therapeutic alternative in the control of partial seizures and secondary generalized clonic seizures. EA promotes the release of neurotransmitters such as GABA and some opioids. The present study aimed to evaluate the anticonvulsive and neuromodulatory effects of Shui Gou DM26 (SG_DM26) acupuncture point electrostimulation on the expression of the glutamate decarboxylase 67 (GAD67) enzyme and the glutamate transporter EAAC1 in an early SE model. At ten postnatal days (10-PD), male rats weighing 22–26 g were divided into 16 groups, including control and treatment groups: Simple stimulation, electrostimulation, anticonvulsant drug treatment, and combined treatment—electrostimulation and pentobarbital (PB). SE was induced with kainic acid (KA), and the following parameters were measured: Motor behavior, and expression of GAD67 and EAAC1. The results suggest an antiepileptic effect derived from SG DM26 point EA. The possible mechanism is most likely the increased production of the inhibitory neurotransmitter GABA, which is observed as an increase in the expression of both GAD67 and EAAC1, as well as the potential synergy between the neuromodulator effects of EA and PB.

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Dutta, Rajeev R., Bryce Picton, Nolan J. Brown, Chenyi Yang, Maxwell Lee, Hana Sung, Alexander M. Lopez, and Michelle Paff. "Schizophrenia and neurosurgery: systematic review and theories." Neurosurgical Focus 54, no. 2 (February 2023): E7. http://dx.doi.org/10.3171/2022.11.focus22620.

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OBJECTIVE Despite its relatively low prevalence, schizophrenia has a high burden of illness due to its lifelong effects and the fact that it is often refractory to psychotropic treatment. This review investigated how neurosurgical interventions, primarily neuromodulation through deep brain stimulation (DBS), can mitigate treatment-refractory schizophrenia. Pathophysiological data and ongoing clinical trials were reviewed to suggest which targets hold promise for neurosurgical efficacy. METHODS A systematic review of the literature was conducted via an electronic search of the PubMed, Scopus, and Web of Science databases. Included papers were human or animal studies of neurosurgical interventions for schizophrenia conducted between 2012 and 2022. An electronic search of ClinicalTrials.gov and the International Clinical Trials Registry Platform was conducted to find ongoing clinical trials. The ROBINS-I (Risk of Bias in Nonrandomized Studies of Interventions) assessment tool was used to evaluate risk of bias in the study. RESULTS Eight human and 2 rat studies were included in the review. Of the human studies, 5 used DBS targeting the nucleus accumbens, subgenual anterior cingulate cortex, habenula, and substantial nigra pars reticulata. The remaining 3 human studies reported the results of subcaudate tractotomies and anterior capsulotomies. The rat studies investigated DBS of the nucleus accumbens and medial prefrontal cortex. Overall, human studies demonstrated long-term reduction in Positive and Negative Syndrome Scale scores in many participants, with a low incidence of surgical and psychological side effects. The rat studies demonstrated improved prepulse and latent inhibition in the targeted areas after DBS. CONCLUSIONS As identified in this review, recent studies have investigated the potential effects of therapeutic DBS for schizophrenia, with varying results. DBS targets that have been explored include the hippocampus, subgenual anterior cingulate cortex, habenula, substantia nigra pars reticulata, and medial prefrontal cortex. In addition to DBS, other neuromodulatory techniques such as neuroablation have been studied. Current evidence suggests that neuroablation in the subcaudate tract and anterior capsulotomy may be beneficial for some patients. The authors recommend further exploration of neuromodulation for treatment-refractory schizophrenia, under the condition that rigorous standards be upheld when considering surgical candidacy for these treatments, given that their safety and efficacy remain to be determined.

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Zhu, Huanqun. "Implanted Electrodes and Microneedle Array Electrodes for the Neuromodulation." Highlights in Science, Engineering and Technology 23 (December 3, 2022): 192–97. http://dx.doi.org/10.54097/hset.v23i.3266.

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In the human body, nerve conduction plays an important role. A range of physiological reactions and movements in the human body require nerves for transmission. Nerves realize the function of conduction by transmitting bio-electrical signals. If the nerves are damaged, the biological signals will not be transmitted, so the human body's reactions cannot be carried out, causing serious consequences. Neuromodulation is an effective treatment modality for patients with nerve damage. Neuromodulation has been proven to have effective therapeutic effects in various brain and neurological diseases. Among them, the electrodes in the neuromodulator regulate the abnormalities of the brain or neurons by releasing electromagnetic pulses, which are an important part of the whole device. However, various electrodes can be used for neuromodulation, and different electrodes have different characteristics from one another. In this study, several electrodes that can be used as wearable/implantable neuromodulators and their properties will be investigated and whether there is a relationship between them.

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Li, Xuanfei, Zheng Liu, He Jin, Xia Fan, Xue Yang, Wanqi Tang, Jun Yan, and Huaping Liang. "Agmatine Protects against Zymosan-Induced Acute Lung Injury in Mice by Inhibiting NF-κB-Mediated Inflammatory Response." BioMed Research International 2014 (2014): 1–10. http://dx.doi.org/10.1155/2014/583736.

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Acute lung injury (ALI) is characterized by overwhelming lung inflammation and anti-inflammation treatment is proposed to be a therapeutic strategy for ALI. Agmatine, a cationic polyamine formed by decarboxylation of L-arginine, is an endogenous neuromodulator that plays protective roles in diverse central nervous system (CNS) disorders. Consistent with its neuromodulatory and neuroprotective properties, agmatine has been reported to have beneficial effects on depression, anxiety, hypoxic ischemia, Parkinson’s disease, and gastric disorder. In this study, we tested the effect of agmatine on the lung inflammation induced by Zymosan (ZYM) challenge in mice. We found that agmatine treatment relieved ZYM-induced acute lung injury, as evidenced by the reduced histological scores, wet/dry weight ratio, and myeloperoxidase activity in the lung tissue. This was accompanied by reduced levels of TNF-α, IL-1β, and IL-6 in lung and bronchoalveolar lavage fluid and decreased iNOS expression in lung. Furthermore, agmatine inhibited the phosphorylation and degradation of IκB and subsequently blocked the activation of nuclear factor (NF)-κB induced by Zymosan. Taken together, our results showed that agmatine treatment inhibited NF-κB signaling in lungs and protected mice against ALI induced by Zymosan, suggesting agmatine may be a potential safe and effective approach for the treatment of ALI.

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Nahai, Foad, Z. Paul Lorenc, Jeffrey M. Kenkel, Steven Fagien, Haideh Hirmand, Mark S. Nestor, Anthony P. Sclafani, Jonathan M. Sykes, and Heidi A. Waldorf. "Expanding Treatment Options for Neuromodulators." Aesthetic Surgery Journal 33, no. 1_Supplement (March 1, 2013): 7S—8S. http://dx.doi.org/10.1177/1090820x12474628.

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Mohammed Naguib Aref (MSCh), Hend, Hossam El Din Fathallah El Sawy (MD), Mai Abd El Raouf Essea (MD), and Ehab Sayed Ramadan (MD). "TREATMENT-RESISTANT OBSESSIVE COMPULSIVE DISORDER: AN EVALUATION STUDY OF THE AUGMENTATION EFFECT OF LOW-FREQUENCY REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION." International Journal of Advanced Research 8, no. 10 (October 31, 2020): 1286–96. http://dx.doi.org/10.21474/ijar01/11967.

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Background: Thelifetime prevalence of obsessive-compulsive disorders (OCD) is estimated to be around 3% in the general population. Selective serotonin reuptake inhibitors (SSRIs) are considered to be the primary treatment strategy of OCD in addition to psychotherapy. Unfortunately, current medications, augmentation strategies, and behavioral therapies fail to provide adequate benefits in many cases. A large percentage of patients (40-60%) do not show satisfactory response to the standard treatments, some of them experiencing a chronically deteriorating course, leading to marked interpersonal and occupational impairments. In recent years, non-invasive neuromodulatory techniques such as repetitive transcranial magnetic stimulation have been increasingly studied as potential adjunct or alternative therapies for a wide range of neurological and psychiatric conditions including pain disorder, depression, and stroke rehabilitation and OCD. Aims: the aim of this work to evaluate rTMS as an augmentation strategy in treatment-resistant OCD, to test the potential value oflow frequency rTMS to SMA,orbitofrontal cortex and right DLPFC in the treatment of resistant OCD and to compare between the therapeutic values of applying the TMS coil to those different areas of the cortex. Patients and Methods: This study was carried out in Psychiatry, Neurology and Neurosurgery Center, Tanta University from September 2017 to November 2019. Eighty patients (52 females and 28 males) aging between 18 and 65 years underwent complete psychiatric evaluation, including full medical history, psychiatric and physical examination and diagnosed as having OCD accordingto DSM-5 with failure of at least two adequate therapeutic trials of SRIs. Results: Before rTMS sessions there was no statistical significant difference between the three active groups and the sham group regarding the scores onYale-Brown obsessive compulsive scale,Hamilton anxiety rating scale, Hamilton depression rating scale and Clinical global impression scale. Results after rTMS sessions revealed the following: Active rTMS on the SMA, the left OFC and right DLPFC was associated with marked improvement in YBOCS, Hamilton anxiety rating scale, Hamilton Depression rating scale and clinical global impression scale. The most significant improvement in Yale Brown Obsessive Compulsive scale was obtained when the brain target was the SMA. The most significant improvement in anxiety rating scale and depression ratingscale was obtained when the brain target was the left OFC. Sham group didnt have significant improvement through the study. Conclusions: We can thus conclude that low frequency rTMS is significantly effective as an adjunctive treatment for resistant OCD and that the SMA is the most effective brain target.

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Barman, Dhunusmita, Nikita Dey, Srijani Sen, Bibhuti Kakoti, and Catherine Vanlalhriatpuii. "Neuromodulatory effect of plant metabolites." Sciences of Phytochemistry 1, no. 1 (July 26, 2022): 47–69. http://dx.doi.org/10.58920/sciphy01010047.

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Neurological disorders (NDDs) are diseases that affect the central and peripheral nervous systems. Gradual malfunction and destruction of the neurons or the nerve cells characterize them. Every year, NDDs affect millions of people worldwide. Over the years, several neuromodulatory techniques have been introduced to improve the quality of life for those affected by NDDs. NDDs are chronic and incurable conditions, however, bioactive substances derived from medicinal plants have emerged as the greatest choice for their prevention and treatment. Literature evidences several benefits of plant metabolites as alternative medicines for the prevention and treatment of NDDs. Numerous investigations have shown plant metabolites to possess beneficial biological effects because of their qualities, which include but are not limited to anti-inflammatory, antioxidant, and neuroprotective actions. Practices of folk medicine and several studies have also guided many phytopharmacological interventions toward the treatment of NDDs. This review aims to highlight secondary metabolites (alkaloids, flavonoids, steroids, terpenoids) of plants with neuroprotective action that could potentially play an important role in the prevention and management of NDDs.

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Aschenbeck, Kelly A., Maria K. Hordinsky, William R. Kennedy, Gwen Wendelschafer-Crabb, Marna E. Ericson, Sima Kavand, Ana Bertin, Dennis D. Dykstra, and Ioanna G. Panoutsopoulou. "Neuromodulatory treatment of recalcitrant plaque psoriasis with onabotulinumtoxinA." Journal of the American Academy of Dermatology 79, no. 6 (December 2018): 1156–59. http://dx.doi.org/10.1016/j.jaad.2018.07.058.

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Zeidler, Claudia, Manuel Pereira, and Sonja Ständer. "The Neuromodulatory Effect of Antipruritic Treatment of Chronic Prurigo." Dermatology and Therapy 9, no. 4 (September 11, 2019): 613–22. http://dx.doi.org/10.1007/s13555-019-00321-6.

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Jensen, Mark P., Leslie H. Sherlin, Felipe Fregni, Ann Gianas, Jon D. Howe, and Shahin Hakimian. "Baseline Brain Activity Predicts Response to Neuromodulatory Pain Treatment." Pain Medicine 15, no. 12 (December 2014): 2055–63. http://dx.doi.org/10.1111/pme.12546.

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Shah, Eric D., Jessica K. Salwen-Deremer, Peter R. Gibson, Jane G. Muir, Shanti Eswaran, and William D. Chey. "Pharmacologic, Dietary, and Psychological Treatments for Irritable Bowel Syndrome With Constipation: Cost Utility Analysis." MDM Policy & Practice 6, no. 1 (January 2021): 238146832097841. http://dx.doi.org/10.1177/2381468320978417.

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Introduction. Irritable bowel syndrome (IBS) is the most common gastroenterology referral and one of the most common gastrointestinal complaints in primary care. We performed a cost-utility analysis of the most common treatments available in general practice for IBS with constipation (IBS-C), the most expensive IBS subtype. Methods. We developed a decision analytic model evaluating guideline-recommended and Food and Drug Administration–approved drugs, supplements, and dietary/psychological interventions. Model inputs were derived from “global symptom improvement” outcomes in systematic reviews of clinical trials. Costs were derived from national datasets. Analysis was performed with a 1-year time horizon from patient and payer perspectives. We analyzed a prototypical managed-care health plan with no cost-sharing to the patient. Results. From a payer perspective, global IBS treatments (including low FODMAP, cognitive behavioral therapy [CBT], neuromodulators), which are not specific to the IBS-C bowel subtype were less expensive than on-label prescription drug treatments. From a patient perspective, on-label prescription drug treatment with linaclotide was the least expensive treatment strategy. Drug prices and costs to manage untreated IBS-C were most important determinants of payer treatment preferences. Effects of treatment on missed work-days and need for repeated appointments to complete treatment were the most important determinants of treatment preference to patients. Discussion. Due mostly to prescription drug prices, neuromodulators, low FODMAP, and CBT appear cost-effective compared to on-label drug treatments from a payer perspective in cost-utility analysis. These findings may explain common treatment barriers in clinical practice.

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Novak, L. P., and O. V. Tumanova. "Citicoline in ophthalmologic practice: neuroprotection in ischemic optic neuropathy, diabetic retinopathy and amblyopia." Archive of Ukrainian Ophthalmology 9, no. 1 (April 29, 2021): 28–33. http://dx.doi.org/10.22141/2309-8147.9.1.2021.229521.

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Decrease and loss of vision are extremely important problems, quite common conditions that lead to disability. The most common causes are ischemic optic neuropathy, diabetic retinopathy, and amblyopia. The pathogenesis of these diseases is characterized by neurodegeneration, loss of structure and function of neurons. Citicoline may be considered for neuroprotection as the drug of choice in these clinical situations. Citicoline has antioxidant and anti-inflammatory properties, it reduces lipid peroxidation and the formation of free radicals, has anti-apoptotic and membrane-protective effects. The drug has a neuromodulatory effect and also contributes to the preservation of sphingomyelin, which ensures signal transmission in nerve cells. In ischemic optic neuropathy, oral citicoline can reduce nerve fiber loss and improve retinal ganglion cell function and visual tract function. In diabetic retinopathy, citicoline prevents synapse loss and improves macular and retinal ganglion cell function. In amblyopia, citicoline stimulates the function of neurotransmitters and neuromodulators, including an increase in the activity of endogenous dopamine and, at the same time, an improvement in the vascular aspects of neurological function. Axobrex is a convenient oral form of citicoline. With oral administration, the bioavailability of citicoline exceeds 90 %, Axobrex is non-toxic and very well-tolerated. The dosage regimen of Axobrex is simple, which contributes to satisfactory patient adherence to treatment. The use of Axobrex in patients with ischemic optic neuropathy, diabetic retinopathy, and amblyopia has an optimal balance of benefits and safety and is advisable for neuroprotection.

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Foit, Niels Alexander, Andrea Bernasconi, and Neda Ladbon-Bernasconi. "Contributions of Imaging to Neuromodulatory Treatment of Drug-Refractory Epilepsy." Brain Sciences 10, no. 10 (October 2, 2020): 700. http://dx.doi.org/10.3390/brainsci10100700.

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Epilepsy affects about 1% of the world’s population, and up to 30% of all patients will ultimately not achieve freedom from seizures with anticonvulsive medication alone. While surgical resection of a magnetic resonance imaging (MRI) -identifiable lesion remains the first-line treatment option for drug-refractory epilepsy, surgery cannot be offered to all. Neuromodulatory therapy targeting “seizures” instead of “epilepsy” has emerged as a valuable treatment option for these patients, including invasive procedures such as deep brain stimulation (DBS), responsive neurostimulation (RNS) and peripheral approaches such as vagus nerve stimulation (VNS). The purpose of this review is to provide in-depth information on current concepts and evidence on network-level aspects of drug-refractory epilepsy. We reviewed the current evidence gained from studies utilizing advanced imaging methodology, with a specific focus on their contributions to neuromodulatory therapy.

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Fadgyas Stanculete, Mihaela, Dan Lucian Dumitrascu, and Douglas Drossman. "Neuromodulators in the Brain-Gut Axis: their Role in the Therapy of the Irritable Bowel Syndrome." Journal of Gastrointestinal and Liver Diseases 30, no. 4 (November 23, 2021): 517–25. http://dx.doi.org/10.15403/jgld-4090.

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Irritable bowel syndrome (IBS) is a clinically well-defined chronic condition that is now understood as a disorder of gut-brain regulation, as established in the work of the Rome IV committees coordinated by Drossman, 2016. People with IBS often report high disability levels and poor health-related quality of life. Drug therapy focuses on reducing main symptoms and disability and improving health-related quality of life. Central neuromodulators reduce IBS symptoms by targeting dysregulated pain and motility related to gut-brain dysregulation. It can also treat associated mental health symptoms. Based on their multiple effects on central and peripheral mechanisms, neuromodulators have been used to treat IBS patients. This review presents the rationale supporting medication treatments for specific IBS symptoms, discusses evidence-based management of IBS with central neuromodulators, and reviews the progress in the research for new neuromodulators.

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Journal articles on the topic 'Neuromodulatory treatments'

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