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Journal articles on the topic 'Neurostimulator'

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Author: Grafiati

Published: 4 June 2021

Last updated: 11 March 2023

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1

Barbaro, Michael F., Kelsi Chesney, Daniel R. Kramer, Spencer Kellis, Terrance Peng, Zack Blumenfeld, Angad S. Gogia, et al. "Dual responsive neurostimulation implants for epilepsy." Journal of Neurosurgery 132, no. 1 (January 2020): 225–31. http://dx.doi.org/10.3171/2018.8.jns181362.

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Closed-loop brain-responsive neurostimulation via the RNS System is a treatment option for adults with medically refractory focal epilepsy. Using a novel technique, 2 RNS Systems (2 neurostimulators and 4 leads) were successfully implanted in a single patient with bilateral parietal epileptogenic zones. In patients with multiple epileptogenic zones, this technique allows for additional treatment options. Implantation can be done successfully, without telemetry interference, using proper surgical planning and neurostimulator positioning.Trajectories for the depth leads were planned using neuronavigation with CT and MR imaging. Stereotactic frames were used for coordinate targeting. Each neurostimulator was positioned with maximal spacing to avoid telemetry interference while minimizing patient discomfort. A separate J-shaped incision was used for each neurostimulator to allow for compartmentalization in case of infection. In order to minimize surgical time and risk of infection, the neurostimulators were implanted in 2 separate surgeries, approximately 3 weeks apart.The neurostimulators and leads were successfully implanted without adverse surgical outcomes. The patient recovered uneventfully, and the early therapy settings over several months resulted in preliminary decreases in aura and seizure frequency. Stimulation by one of the neurostimulators did not result in stimulation artifacts detected by the contralateral neurostimulator.

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Saha, Renata, Kai Wu, Robert P. Bloom, Shuang Liang, Denis Tonini, and Jian-Ping Wang. "A review on magnetic and spintronic neurostimulation: challenges and prospects." Nanotechnology 33, no. 18 (February 10, 2022): 182004. http://dx.doi.org/10.1088/1361-6528/ac49be.

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Abstract In the treatment of neurodegenerative, sensory and cardiovascular diseases, electrical probes and arrays have shown quite a promising success rate. However, despite the outstanding clinical outcomes, their operation is significantly hindered by non-selective control of electric fields. A promising alternative is micromagnetic stimulation (μMS) due to the high permeability of magnetic field through biological tissues. The induced electric field from the time-varying magnetic field generated by magnetic neurostimulators is used to remotely stimulate neighboring neurons. Due to the spatial asymmetry of the induced electric field, high spatial selectivity of neurostimulation has been realized. Herein, some popular choices of magnetic neurostimulators such as microcoils (μcoils) and spintronic nanodevices are reviewed. The neurostimulator features such as power consumption and resolution (aiming at cellular level) are discussed. In addition, the chronic stability and biocompatibility of these implantable neurostimulator are commented in favor of further translation to clinical settings. Furthermore, magnetic nanoparticles (MNPs), as another invaluable neurostimulation material, has emerged in recent years. Thus, in this review we have also included MNPs as a remote neurostimulation solution that overcomes physical limitations of invasive implants. Overall, this review provides peers with the recent development of ultra-low power, cellular-level, spatially selective magnetic neurostimulators of dimensions within micro- to nano-range for treating chronic neurological disorders. At the end of this review, some potential applications of next generation neuro-devices have also been discussed.

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3

Johnson, Matthew R., Daniel J. Tomes, John S. Treves, and Lyal G. Leibrock. "Minimally invasive implantation of epidural spinal cord neurostimulator electrodes by using a tubular retractor system." Journal of Neurosurgery 100, no. 6 (June 2004): 1119–21. http://dx.doi.org/10.3171/jns.2004.100.6.1119.

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✓ The authors describe a novel technique for the implantation of multipolar epidural spinal cord neurostimulator electrodes with the aid of a tubular retractor system. Spinal cord neurostimulation is used as a neuroaugmentive tool for treating chronic intractable pain syndromes. Minimally invasive placement of the multipolar neurostimulator electrodes may allow for shorter hospital stays and less postoperative pain associated with the incision.

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4

ter Bruggen, Feline F. J. A., Dirk L. Stronks, and Frank J. P. M. Huygen. "Survey on sedation-analgesia regimens, in particular the use of dexmedetomidine, among Dutch implanters of spinal cord neurostimulators." Scandinavian Journal of Pain 19, no. 4 (October 25, 2019): 823–27. http://dx.doi.org/10.1515/sjpain-2019-0058.

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Abstract Background and aims During implantation of most spinal cord neurostimulators, patients need to be cooperative to give feedback during lead placement, and also be comfortable. Sedation and analgesia can support these conditions. This survey aimed to provide an overview of the sedation-analgesia regimens currently used among Dutch pain specialists. The survey focused on the sedative agent “dexmedetomidine” due to its attractive pharmacological profile and its promising results during awake procedures. Methods A 27-item survey was sent to the 65 pain specialists involved in neurostimulation in the Netherlands. The survey consisted of questions related to different aspects of sedation and analgesia during neurostimulation, e.g. the current regimen, the opinion on and experience with dexmedetomidine as a sedative agent, and preferences regarding different aspects of sedation (i.e. production of arousable sedation, pain management, quality of patient’s feedback and overall preference). Results Of 65 pain specialists, 45 (69%) completed the survey. Most commonly used sedative was propofol (91%) and most common used analgesic was remifentanil (78%). Of the 45 respondents, 21 (47%) considered the use of dexmedetomidine, whereas 13 (29%) had experience with dexmedetomidine during neurostimulation. The most frequently mentioned positive property of dexmedetomidine was the easy production of arousable sedation. Most respondents who used dexmedetomidine preferred dexmedetomidine sedation over propofol sedation regarding all aspects of sedation. Conclusions The most commonly used sedation-analgesia regimen is the combination of propofol-remifentanil during the implantation of a neurostimulator among Dutch pain specialists. Only a small percentage of respondents had experience with the use of dexmedetomidine, despite its reported advantages. Implications When implanting a spinal cord neurostimulator, dexmedetomidine could be considered as a sedative, given its allowance for and preservation of a state of easy arousable sedation.

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5

Sarwat, Amr Mohamed, Kota Sadashiv Karanth, and John Christopher Sutcliffe. "A rare complication of hardware failure in neurostimulation." Journal of Neurosurgery: Spine 93, no. 2 (October 2000): 330–31. http://dx.doi.org/10.3171/spi.2000.93.2.0330.

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✓ The authors report on a rare complication of neurostimulation. Two patients presented with a skin rash after undergoing neurostimulator implantation, and the implants were found to have faulty electrical insulation. The rash was centered over the source of current leak and disappeared when the problem was corrected.

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6

Philipp, Lucas R., Mark R. Witcher, and Robert E. Gross. "A Novel Approach for Responsive Neural Stimulator Implantation With Infraclavicular Placement of the Internal Pulse Generator." Operative Neurosurgery 15, no. 6 (March 14, 2018): 711–19. http://dx.doi.org/10.1093/ons/opy025.

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Abstract INTRODUCTION The Responsive Neurostimulation System (RNS, Neuropace, Mountain View, California) has been proven to be effective at reducing seizures in patients with partial-onset epilepsy. The system incorporates a skull-mounted neurostimulator that requires a cranial incision for replacement. Although integral to the functioning of the system, in some circumstances, such as in the setting of infection, this can be disadvantageous. At present, there are no alternatives to cranial implantation of the RNS System. METHODS We describe a novel procedure enabling implantation of the neurostimulator within the chest wall, using components from a peripheral nerve stimulator. In a patient who achieved complete seizure freedom with the use of the RNS System, distant site implantation provided a viable means of continuing therapy in a setting where device explantation would have otherwise been inevitable as a result of cranial infection. We present continuous electrocorticographic data recorded from the device documenting the performance of the system with the subclavicular neurostimulator. RESULTS Band pass detection rates increased by 50%, while line length detection rates decreased by 50%. The number of detections decreased from 1046 to 846, with a resultant decrease in stimulations. Although there was some compromise of function due to the elevated noise floor, more than 2 yr following the procedure the patient remains free of seizures and infection. CONCLUSION The salvage procedure we describe offered an alternative therapeutic option in a patient with a complicated cranial wound issue, using heterogeneous components with marginal compromises in device functionality and no sacrifice in patient outcome.

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7

&NA;. "New Spinal Neurostimulator." Journal of Clinical Engineering 29, no. 3 (2004): 116. http://dx.doi.org/10.1097/00004669-200407000-00017.

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8

Schaldach, M., H. Hütten, J. Jirmann, and U. Krainick. "IMPLANTIERBARER MEHRKANALIGER NEUROSTIMULATOR." Biomedizinische Technik/Biomedical Engineering 35, s3 (1990): 126–30. http://dx.doi.org/10.1515/bmte.1990.35.s3.126.

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9

Juncker, Ryan B., Joel J. Gagnier, and Faisal M. Mirza. "Neurostimulation as an Efficacious Nonpharmacologic Analgesic following Arthroscopic Rotator Cuff Repair." Case Reports in Anesthesiology 2022 (April 15, 2022): 1–5. http://dx.doi.org/10.1155/2022/2133998.

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This case highlights the importance of pursuing nonpharmacologic analgesic modalities in orthopedic surgery to combat the current opioid epidemic. Presented is a patient who underwent an arthroscopic rotator cuff repair and biceps tenodesis operation and through the use of neurostimulation (in the form of auricular electrostimulation), fully recovered from surgery without the usage of any opioid or nonsteroidal anti-inflammatory medications. The patient was fitted with a novel auricular electrostimulation device (DyAnsys Primary Relief) in the immediate postoperative period that provided constant neurostimulation for 10 days, this neurostimulator was the only analgesic modality used in this case, and the patient reported minimal postoperative pain. The utility of this case centers around the lack of postoperative opioid use, presenting the idea that postsurgical orthopedic pain can be managed in a nonpharmacologic capacity, combatting the fields’ ongoing opioid epidemic.

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10

Hansmeyer, Laura, and Thilo B. Krueger. "Synchronized presentation of a language task to the electrical stimulation of cortical regions during speech mapping in an awake surgery." Current Directions in Biomedical Engineering 4, no. 1 (September 1, 2018): 547–50. http://dx.doi.org/10.1515/cdbme-2018-0131.

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AbstractIntraoperative speech mapping is performed to preserve language function during tumour resections that involve eloquent cortical areas. For this technique the synchronization of the picture presentation to the patient with the electrical stimulation of the cortex is of major importance. During the operative routine images are manually presented by a psychologist or neurologist to the patient and have to be coordinated with the neurosurgeon stimulating the cortex by a neurostimulator, operated by an engineer. To increase the efficiency of this procedure and to minimize the time needed to localize functional cortical areas, images should appear automatically with electrical stimulation. To achieve this synchronization, the potential combination of an existing neurostimulator with commercially available software for image display was studied. A trigger signal was created to induce the presentation of a series of line drawings showing different objects. The software to control the neurostimulator and the software for image displaying were installed on two different computers. A cable was developed to transfer the trigger signal from the neurostimulator to the computer used for picture presentation. It was shown that it is possible to induce the image display via the neurostimulator using square-wave pulses of 5 V and a width of 10 ms. Thus, we present a system that enables the automated picture presentation synchronized to the electrical stimulation of cortical regions.

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Molina, Rene, Michael S. Okun, Jonathan B. Shute, Enrico Opri, P. Justin Rossi, Daniel Martinez-Ramirez, Kelly D. Foote, and Aysegul Gunduz. "Report of a patient undergoing chronic responsive deep brain stimulation for Tourette syndrome: proof of concept." Journal of Neurosurgery 129, no. 2 (August 2018): 308–14. http://dx.doi.org/10.3171/2017.6.jns17626.

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Deep brain stimulation (DBS) has emerged as a promising intervention for the treatment of select movement and neuropsychiatric disorders. Current DBS therapies deliver electrical stimulation continuously and are not designed to adapt to a patient’s symptoms. Continuous DBS can lead to rapid battery depletion, which necessitates frequent surgery for battery replacement. Next-generation neurostimulation devices can monitor neural signals from implanted DBS leads, where stimulation can be delivered responsively, moving the field of neuromodulation away from continuous paradigms. To this end, the authors designed and chronically implemented a responsive stimulation paradigm in a patient with medically refractory Tourette syndrome. The patient underwent implantation of a responsive neurostimulator, which is capable of responsive DBS, with bilateral leads in the centromedian-parafascicular (Cm-Pf) region of the thalamus. A spectral feature in the 5- to 15-Hz band was identified as the control signal. Clinical data collected prior to and after 12 months of responsive therapy revealed improvements from baseline scores in both Modified Rush Tic Rating Scale and Yale Global Tic Severity Scale scores (64% and 48% improvement, respectively). The effectiveness of responsive stimulation (p = 0.16) was statistically identical to that of scheduled duty cycle stimulation (p = 0.33; 2-sided Wilcoxon unpaired rank-sum t-test). Overall, responsive stimulation resulted in a 63.3% improvement in the neurostimulator’s projected mean battery life. Herein, to their knowledge, the authors present the first proof of concept for responsive stimulation in a patient with Tourette syndrome.

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12

Starkebaum, Warren, and Mark T. Rise. "Ultrasonic techniques for neurostimulator control." Journal of the Acoustical Society of America 102, no. 6 (1997): 3254. http://dx.doi.org/10.1121/1.420253.

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13

&NA;. "Neurostimulator Approved for Chronic Pain." Journal of Clinical Engineering 30, no. 3 (July 2005): 126–27. http://dx.doi.org/10.1097/00004669-200507000-00034.

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14

Schaldach, M., H. Hutten, J. Jirmann, and U. Kratnick. "IMPLANTIERBARER NEUROSTIMULATOR MIT PROGRAMMIERBARER LOGIK." Biomedizinische Technik/Biomedical Engineering 35, s2 (1990): 138–40. http://dx.doi.org/10.1515/bmte.1990.35.s2.138.

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15

Geuting, Markus. "Periphere Nervenstimulation mit extrakorporalem Neurostimulator." Schmerzmedizin 35, no. 1 (January 2019): 19–23. http://dx.doi.org/10.1007/s00940-019-0981-0.

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16

Boon, Paul, and Kristl Vonck. "Neurostimulation as a Treatment Option for Epilepsy." European Neurological Review 5, no. 1 (2010): 92. http://dx.doi.org/10.17925/enr.2010.05.01.92.

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Although neurostimulation is not a new treatment modality, it is an emerging treatment for various neurological diseases. Currently available pharmacological and surgical treatments leave about 30% of patients not seizure-free. Electrical stimulation of the 10th cranial nerve or vagus nerve stimulation (VNS) is an extracranial type of stimulation that is currently routinely available. Through an implanted device and electrode, electrical pulses are administered to the afferent fibres of the left vagus nerve in the neck. VNS is indicated in patients with refractory epilepsy who are unsuitable candidates for epilepsy surgery or who have had insufficient benefit from such a treatment. Intracerebral neurostimulation requires accessing the intracranial nervous system as stimulation electrodes are inserted into intracerebral targets for deep brain stimulation (DBS) or placed over the cortical convexity for cortical stimulation (CS). Recently, trials with DBS in different intracerebral structures such as the thalamus, the subthalamic nucleus and medial temporal lobe structures have been performed. CS ± DBS in a closed-loop system (responsive neurostimulator system [RNS]) is currently being investigated in a multicentre trial. It is likely that neurostimulation for epilepsy will become a more practical and more widely used treatment modality for patients with refractory epilepsy.

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Takeuchi, Masaru, Keita Watanabe, Kanta Ishihara, Taichi Miyamoto, Katsuhiro Tokutake, Sota Saeki, Tadayoshi Aoyama, Yasuhisa Hasegawa, Shigeru Kurimoto, and Hitoshi Hirata. "Visual Feedback Control of a Rat Ankle Angle Using a Wirelessly Powered Two-Channel Neurostimulator." Sensors 20, no. 8 (April 14, 2020): 2210. http://dx.doi.org/10.3390/s20082210.

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Peripheral nerve disconnections cause severe muscle atrophy and consequently, paralysis of limbs. Reinnervation of denervated muscle by transplanting motor neurons and applying Functional Electrical Stimulation (FES) onto peripheral nerves is an important procedure for preventing irreversible degeneration of muscle tissues. After the reinnervation of denervated muscles, multiple peripheral nerves should be stimulated independently to control joint motion and reconstruct functional movements of limbs by the FES. In this study, a wirelessly powered two-channel neurostimulator was developed with the purpose of applying selective FES to two peripheral nerves—the peroneal nerve and the tibial nerve in a rat. The neurostimulator was designed in such a way that power could be supplied wirelessly, from a transmitter coil to a receiver coil. The receiver coil was connected, in turn, to the peroneal and tibial nerves in the rat. The receiver circuit had a low pass filter to allow detection of the frequency of the transmitter signal. The stimulation of the nerves was switched according to the frequency of the transmitter signal. Dorsal/plantar flexion of the rat ankle joint was selectively induced by the developed neurostimulator. The rat ankle joint angle was controlled by changing the stimulation electrode and the stimulation current, based on the Proportional Integral (PI) control method using a visual feedback control system. This study was aimed at controlling the leg motion by stimulating the peripheral nerves using the neurostimulator.

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Ault, Alicia. "Medicare Cuts Reimbursement For Neurostimulator Devices." Clinical Neurology News 2, no. 11 (November 2006): 23. http://dx.doi.org/10.1016/s1553-3212(06)71724-1.

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Navarro-Fernández, Gonzalo, Lucía de-la-Puente-Ranea, Marisa Gandía-González, and Alfonso Gil-Martínez. "Endogenous Neurostimulation and Physiotherapy in Cluster Headache: A Clinical Case." Brain Sciences 9, no. 3 (March 12, 2019): 60. http://dx.doi.org/10.3390/brainsci9030060.

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Objective: The aim of this paper is to describe the progressive changes of chronic cluster headaches (CHs) in a patient who is being treated by a multimodal approach, using pharmacology, neurostimulation and physiotherapy. Subject: A male patient, 42 years of age was diagnosed with left-sided refractory chronic CH by a neurologist in November 2009. In June 2014, the patient underwent a surgical intervention in which a bilateral occipital nerve neurostimulator was implanted as a treatment for headache. Methods: Case report. Results: Primary findings included a decreased frequency of CH which lasted up to 2 months and sometimes even without pain. Besides this, there were decreased levels of anxiety, helplessness (PCS subscale) and a decreased impact of headache (HIT-6 scale). Bilateral pressure pain thresholds (PPTs) were improved along with an increase in strength and motor control of the neck muscles. These improvements were present at the conclusion of the treatment and maintained up to 4 months after the treatment. Conclusions: A multimodal approach, including pharmacology, neurostimulation and physiotherapy may be beneficial for patients with chronic CHs. Further studies such as case series and clinical trials are needed to confirm these results.

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20

Jakobs, Martin, Ann-Kristin Helmers, Michael Synowitz, Philipp J. Slotty, Judith M. Anthofer, Jürgen R. Schlaier, Manja Kloss, Andreas W. Unterberg, and Karl L. Kiening. "A multicenter, open-label, controlled trial on acceptance, convenience, and complications of rechargeable internal pulse generators for deep brain stimulation: the Multi Recharge Trial." Journal of Neurosurgery 133, no. 3 (September 2020): 821–29. http://dx.doi.org/10.3171/2019.5.jns19360.

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OBJECTIVERechargeable neurostimulators for deep brain stimulation have been available since 2008, promising longer battery life and fewer replacement surgeries compared to non-rechargeable systems. Long-term data on how recharging affects movement disorder patients are sparse. This is the first multicenter, patient-focused, industry-independent study on rechargeable neurostimulators.METHODSFour neurosurgical centers sent a questionnaire to all adult movement disorder patients with a rechargeable neurostimulator implanted at the time of the trial. The primary endpoint was the convenience of the recharging process rated on an ordinal scale from “very hard” (1) to “very easy” (5). Secondary endpoints were charge burden (time spent per week on recharging), user confidence, and complication rates. Endpoints were compared for several subgroups.RESULTSDatasets of 195 movement disorder patients (66.1% of sent questionnaires) with Parkinson’s disease (PD), tremor, or dystonia were returned and included in the analysis. Patients had a mean age of 61.3 years and the device was implanted for a mean of 40.3 months. The overall convenience of recharging was rated as “easy” (4). The mean charge burden was 122 min/wk and showed a positive correlation with duration of therapy; 93.8% of users felt confident recharging the device. The rate of surgical revisions was 4.1%, and the infection rate was 2.1%. Failed recharges occurred in 8.7% of patients, and 3.6% of patients experienced an interruption of therapy because of a failed recharge. Convenience ratings by PD patients were significantly worse than ratings by dystonia patients. Caregivers recharged the device for the patient in 12.3% of cases. Patients who switched from a non-rechargeable to a rechargeable neurostimulator found recharging to be significantly less convenient at a higher charge burden than did patients whose primary implant was rechargeable. Age did not have a significant impact on any endpoint.CONCLUSIONSOverall, patients with movement disorders rated recharging as easy, with low complication rates and acceptable charge burden.

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Kotecha, Rupesh, Camille A. Berriochoa, Erin S. Murphy, Andre G. Machado, Samuel T. Chao, John H. Suh, and Kevin L. Stephans. "Report of whole-brain radiation therapy in a patient with an implanted deep brain stimulator: important neurosurgical considerations and radiotherapy practice principles." Journal of Neurosurgery 124, no. 4 (April 2016): 966–70. http://dx.doi.org/10.3171/2015.2.jns142951.

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Patients with implanted neuromodulation devices present potential challenges for radiation therapy treatment planning and delivery. Although guidelines exist regarding the irradiation of cardiac pacemakers and defibrillators, fewer data and less clinical experience exist regarding the effects of radiation therapy on less frequently used devices, such as deep brain stimulators. A 79-year-old woman with a history of coarse tremors effectively managed with deep brain stimulation presented with multiple intracranial metastases from a newly diagnosed lung cancer and was referred for whole-brain radiation therapy. She was treated with a German helmet technique to a total dose of 30 Gy in 10 fractions using 6 MV photons via opposed lateral fields with the neurostimulator turned off prior to delivery of each fraction. The patient tolerated the treatment well with no acute complications and no apparent change in the functionality of her neurostimulator device or effect on her underlying neuromuscular disorder. This represents the first reported case of the safe delivery of whole-brain radiation therapy in a patient with an implanted neurostimulator device. In cases such as this, neurosurgeons and radiation oncologists should have discussions with patients about the risks of brain injury, device malfunction or failure of the device, and plans for rigorous testing of the device before and after radiation therapy.

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Streltov, Ion, Marcela Nour, Madalina Radu, Mihai Malcoci, Oana Bisoc, Ecaterina Olaru, and Iulia Aldea. "Use of high performance technologies in the treatment of chronic neuropathic pain." Romanian Neurosurgery 32, no. 1 (March 1, 2018): 3–15. http://dx.doi.org/10.2478/romneu-2018-0001.

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Abstract Spinal cord neurostimulation is a minimally invasive treatment method for chronic neuropathic pain that is refractory to treatment, and is part of top technology in field. Relatively recent introduction of this method in the Neurosurgery Clinic “Prof. Dr. N. Oblu” of Iasi has aligned the clinic’s therapeutic arsenal to world standards. This has made it possible to treat in Romania a category of patients who would be treated abroad until now. Our clinic has entered the “National Program for diagnostic and treatment using high performance equipment” - Subprogram of treatment of neuropathic pain by implant of a spinal cord neurostimulator and is currently the only one in Romania where this treatment can be done. This represents a new step in the transformation process of the Clinical Hospital Emergency “Prof. Dr. N. Oblu” Iasi in a real Center of Excellence in the field Neurosurgery. The team dealing with the implant consists of 3 neurosurgeons, a neurologist, pa sychologist and an anesthetist, trained in a specialized foreign center.

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Yakovlev, A. E., M. V. Yakovleva, M. K. Chaykovskaya, and A. V. Ardashev. "The First in Russia Experience of Successful Implementation of Constant Neurostimulation of the Spinal Cord in the Complex Treatment of a Patient with Permanent Form of Atrial Fibrillation Combined with Spinal Stenosis." Kardiologiia 59, no. 9 (September 21, 2019): 83–90. http://dx.doi.org/10.18087/cardio.2019.9.10272.

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This article describes for the first time in the domestic literature a clinical case of the therapeutic effect of neuromodulation on the permanent form of atrial fibrillation and chronic heart failure in an elderly patient with spinal stenosis which led to the development of pain syndrome and movement disorders. For the treatment of neurological pathology, at the beginning epidural administration of drugs was applied, followed by spinal cord stimulation trial and implantation of permanent neurostimulator. At each stage of treatment conducted by a functional neurosurgeon the patient had a spontaneous restoration of sinus rhythm, and during continuous neurostimulation a stable retention of sinus rhythm and regression of heart failure symptoms have been observed throughout a long observation period. The article also presents the data of a few experimental and clinical studies on the use of neuromodulation in cardiology, describes the method of implantation of spinal electrodes and analyzes possible mechanisms of modulation of the autonomic innervation of the heart, implemented by spinal cord stimulation.

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Innamorato, Massimo Antonio, Marco Cascella, Elena Giovanna Bignami, Paolo Perna, Emiliano Petrucci, Franco Marinangeli, and Alessandro Vittori. "Neurostimulation for Chronic Low Back Pain during Pregnancy: Implications for Child and Mother Safety." International Journal of Environmental Research and Public Health 19, no. 23 (November 22, 2022): 15488. http://dx.doi.org/10.3390/ijerph192315488.

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Pain therapy for low back pain in pregnancy is a very topical issue. In fact, it is necessary to balance the patient’s needs to control pain with the need to manage a pregnancy without negative effects on the fetus. We report a case of a 37-year-old woman with low back pain treated with neurostimulation before pregnancy. She described severe chronic low back pain unresponsive to pharmacologic treatments. We first implanted a subcutaneous stimulator into the patient, and then a definitive stimulator resulting in excellent pain control. The improvement in her quality of life allowed the woman to become pregnant. We decided to stop neurostimulation with the patient during pregnancy. The patient completed her pregnancy without complications and the baby was born healthy. During the pregnancy, the woman took only paracetamol when needed. However, this painful symptomatology, completely anecdotal, is not attributable solely to the previous spine problem but probably also to the changes occurring during pregnancy. At the end of pregnancy, the neurostimulator was reactivated without any discomfort for the patient, who is now pain free. This case report provides a first line of evidence of a possible treatment of low back pain in women intending to become pregnant, with risk-free management for both the patient and the child.

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Mruk, Melanie, Ralf Stroop, Jan Boergel, Norbert M. Lang, Makoto Nakamura, Ralph Lehrke, and Samer Zawy Alsofy. "Neurostimulator-induced ECG artefacts: A systematic analysis." Clinical Neurology and Neurosurgery 203 (April 2021): 106557. http://dx.doi.org/10.1016/j.clineuro.2021.106557.

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Wong, Y. T., N. Dommel, P. Preston, L. E. Hallum, T. Lehmann, N. H. Lovell, and G. J. Suaning. "Retinal Neurostimulator for a Multifocal Vision Prosthesis." IEEE Transactions on Neural Systems and Rehabilitation Engineering 15, no. 3 (September 2007): 425–34. http://dx.doi.org/10.1109/tnsre.2007.903958.

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Li, Wen, Damien C. Rodger, Anderson Pinto, Ellis Meng, James D. Weiland, Mark S. Humayun, and Yu-Chong Tai. "Parylene-based integrated wireless single-channel neurostimulator." Sensors and Actuators A: Physical 166, no. 2 (April 2011): 193–200. http://dx.doi.org/10.1016/j.sna.2010.03.003.

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Chinier, E., O. Hamel, I. Richard, and B. Perrouin-Verbe. "Clinical results of Brindley neurostimulator: Preliminary results." Annals of Physical and Rehabilitation Medicine 56 (October 2013): e82. http://dx.doi.org/10.1016/j.rehab.2013.07.449.

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Li, Xiaolong, Wouter A. Serdijn, Wei Zheng, Yubo Tian, and Bing Zhang. "The injectable neurostimulator: an emerging therapeutic device." Trends in Biotechnology 33, no. 7 (July 2015): 388–94. http://dx.doi.org/10.1016/j.tibtech.2015.04.001.

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Gonzalez, Humberto C., and Vic Velanovich. "Enterra®Therapy: gastric neurostimulator for gastroparesis." Expert Review of Medical Devices 7, no. 3 (May 2010): 319–32. http://dx.doi.org/10.1586/erd.10.4.

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Low, Hu Liang. "Reply: The ‘plait sign’ of neurostimulator torsion." Movement Disorders 25, no. 7 (April 13, 2010): 965–66. http://dx.doi.org/10.1002/mds.23091.

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Weber, Peter B., Ritu Kapur, Ryder P. Gwinn, Richard S. Zimmerman, Tracy A. Courtney, and Martha J. Morrell. "Infection and Erosion Rates in Trials of a Cranially Implanted Neurostimulator Do Not Increase with Subsequent Neurostimulator Placements." Stereotactic and Functional Neurosurgery 95, no. 5 (2017): 325–29. http://dx.doi.org/10.1159/000479288.

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Podugu, Amareshwar, Kanwarpreet Tandon, Andrew Ukleja, Fernando Castro-Pavia, Raul Rosenthal, and Alison Schneider. "Su1059 Can Temporary Gastric Neurostimulator Predict the Symptom Response With a Permanent Gastric Neurostimulator? - A Single Center Experience." Gastrointestinal Endoscopy 83, no. 5 (May 2016): AB313—AB314. http://dx.doi.org/10.1016/j.gie.2016.03.799.

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Lekshmy, H. O., Dhanyalaxmi Panickar, and Sandhya Harikumar. "Comparative analysis of multiple machine learning algorithms for epileptic seizure prediction." Journal of Physics: Conference Series 2161, no. 1 (January 1, 2022): 012055. http://dx.doi.org/10.1088/1742-6596/2161/1/012055.

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Abstract Epilepsy is a common neurological disease that affects more than 2 percent of the population globally. An imbalance in brain electrical activities causes unpredictable seizures, which eventually leads to epilepsy. Neurostimulators have the power to intervene in advance and avoid the occurrence of seizures. Its efficiency can be increased with the help of heuristics like advanced seizure prediction. Early identification of preictal state will help easy activation of neurostimulator on time. This research concentrates on the performance analysis of various machine learning algorithms on recorded EEG data. Through this study, we aim to find the best model, which can be used to create an ensemble model for better learning. This involves modeling and simulation of classical machine learning technique like Logistic regression, Naive Bayes model, K nearest neighbors Random Forest, and deep learning techniques like an Artificial neural network, Convolutional neural networks, Long short term memory, and Autoencoders. In this analysis, Random Forest and Long Short-Term Memory performed well among all models in terms of sensitivity and specificity.

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Jacob, R. Lorie, Jonah Geddes, Shirley McCartney, and Kim J. Burchiel. "Cost analysis of awake versus asleep deep brain stimulation: a single academic health center experience." Journal of Neurosurgery 124, no. 5 (May 2016): 1517–23. http://dx.doi.org/10.3171/2015.5.jns15433.

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OBJECT The objective of this study was to compare the cost of deep brain stimulation (DBS) performed awake versus asleep at a single US academic health center and to compare costs across the University HealthSystem Consortium (UHC) Clinical Database. METHODS Inpatient and outpatient demographic and hospital financial data for patients receiving a neurostimulator lead implant (from the first quarter of 2009 to the second quarter of 2014) were collected and analyzed. Inpatient charges included those associated with International Classification of Diseases, Ninth Revision (ICD-9) procedure code 0293 (implantation or replacement of intracranial neurostimulator lead). Outpatient charges included all preoperative charges ≤ 30 days prior to implant and all postoperative charges ≤ 30 days after implant. The cost of care based on reported charges and a cost-to-charge ratio was estimated. The UHC database was queried (January 2011 to March 2014) with the same ICD-9 code. Procedure cost data across like hospitals (27 UHC hospitals) conducting similar DBS procedures were compared. RESULTS Two hundred eleven DBS procedures (53 awake and 158 asleep) were performed at a single US academic health center during the study period. The average patient age ( ± SD) was 65 ± 9 years old and 39% of patients were female. The most common primary diagnosis was Parkinson’s disease (61.1%) followed by essential and other forms of tremor (36%). Overall average DBS procedure cost was $39,152 ± $5340. Asleep DBS cost $38,850 ± $4830, which was not significantly different than the awake DBS cost of $40,052 ± $6604. The standard deviation for asleep DBS was significantly lower (p ≤ 0.05). In 2013, the median cost for a neurostimulator implant lead was $34,052 at UHC-affiliated hospitals that performed at least 5 procedures a year. At Oregon Health & Science University, the median cost was $17,150 and the observed single academic health center cost for a neurostimulator lead implant was less than the expected cost (ratio 0.97). CONCLUSIONS In this single academic medical center cost analysis, DBS performed asleep was associated with a lower cost variation relative to the awake procedure. Furthermore, costs compared favorably to UHC-affiliated hospitals. While asleep DBS is not yet standard practice, this center exclusively performs asleep DBS at a lower cost than comparable institutions.

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Parker, Jonathon J., Ryan M. Jamiolkowski, Gerald A. Grant, Scheherazade Le, and Casey H. Halpern. "Hybrid Fluoroscopic and Neurophysiological Targeting of Responsive Neurostimulation of the Rolandic Cortex." Operative Neurosurgery 21, no. 3 (June 16, 2021): E180—E186. http://dx.doi.org/10.1093/ons/opab182.

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Abstract BACKGROUND Precise targeting of cortical surface electrodes to epileptogenic regions defined by anatomic and electrophysiological guideposts remains a surgical challenge during implantation of responsive neurostimulation (RNS) devices. OBJECTIVE To describe a hybrid fluoroscopic and neurophysiological technique for targeting of subdural cortical surface electrodes to anatomic regions with limited direct visualization, such as the interhemispheric fissure. METHODS Intraoperative two-dimensional (2D) fluoroscopy was used to colocalize and align an electrode for permanent device implantation with a temporary in Situ electrode placed for extraoperative seizure mapping. Intraoperative phase reversal mapping technique was performed to distinguish primary somatosensory and motor cortex. RESULTS We applied these techniques to optimize placement of an interhemispheric strip electrode connected to a responsive neurostimulator system for detection and treatment of seizures arising from a large perirolandic cortical malformation. Intraoperative neuromonitoring (IONM) phase reversal technique facilitated neuroanatomic mapping and electrode placement. CONCLUSION In challenging-to-access anatomic regions, fluoroscopy and intraoperative neurophysiology can be employed to augment targeting of neuromodulation electrodes to the site of seizure onset zone or specific neurophysiological biomarkers of clinical interest while minimizing brain retraction.

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Koeglsperger, Thomas, Jan H. Mehrkens, and Kai Bötzel. "Bilateral double beta peaks in a PD patient with STN electrodes." Acta Neurochirurgica 163, no. 1 (July 24, 2020): 205–9. http://dx.doi.org/10.1007/s00701-020-04493-5.

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AbstractSubthalamic local field potentials in the beta band are considered as potential biomarkers for closed-loop deep brain stimulation. To investigate the subthalamic beta band peak amplitudes in a Parkinson’s disease patient over an extended period of time by using a novel and commercially available neurostimulator with permanent sensing capability. We recorded local field potentials of the subthalamic nucleus using the Medtronic Percept™ implantable neurostimulator at rest and during physical activity (gait) with and in response to deep brain stimulation. We found a double-peaked beta activity on both sides. Increasing stimulation and physical activity resulted in a decreased beta band amplitude, but was accompanied by the appearance of a second, and previously unrecognized peak at 13 Hz in the right hemisphere. Our results will support the investigation of distinct different peaks in the beta band and their relevance and usefulness as closed-loop biomarkers.

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Raju, G. S., I. Sarosiek, J. Forster, S. Rosenthal, Z. Lin, and R. McCallum. "EUS assisted gastric pacemaker (neurostimulator) implantation for gastroparesis." American Journal of Gastroenterology 95, no. 9 (September 2000): 2599. http://dx.doi.org/10.1111/j.1572-0241.2000.03007.x.

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Kelly, S. K., D. B. Shire, Jinghua Chen, P. Doyle, M. D. Gingerich, S. F. Cogan, W. A. Drohan, et al. "A Hermetic Wireless Subretinal Neurostimulator for Vision Prostheses." IEEE Transactions on Biomedical Engineering 58, no. 11 (November 2011): 3197–205. http://dx.doi.org/10.1109/tbme.2011.2165713.

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Bruelle, P., V. Piffaut, P. Cuvillon, J. Ripart, and J. J. Eledjam. "Iliofascial block with a neurostimulator in adult patients." Regional Anesthesia and Pain Medicine 23, Sup 1 (May 1998): 77. http://dx.doi.org/10.1097/00115550-199823031-00077.

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Zaraska, W., P. Thor, M. Lipiński, M. Cież, W. Grzesiak, J. Początek, and K. Zaraska. "Design and fabrication of neurostimulator implants—selected problems." Microelectronics Reliability 45, no. 12 (December 2005): 1930–34. http://dx.doi.org/10.1016/j.microrel.2005.03.004.

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Li, Z., A. Peterchev, and S. Goetz. "P206 A magnetic neurostimulator with arbitrary pulse shape." Clinical Neurophysiology 131, no. 4 (April 2020): e132. http://dx.doi.org/10.1016/j.clinph.2019.12.317.

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Florian, Marcelo Rossiti, Vera Lucia Rasera Zotelli, Maria da Luz Rosário de Sousa, and Larissa Angélica Bachir Polloni. "Use of Magnetic Neurostimulator Appliance in Temporomandibular Disorder." Journal of Acupuncture and Meridian Studies 10, no. 2 (April 2017): 104–8. http://dx.doi.org/10.1016/j.jams.2017.02.008.

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Roze, Emmanuel, Soledad Navarro, Philippe Cornu, Marie-Laure Welter, and Marie Vidailhet. "DEEP BRAIN STIMULATION OF THE GLOBUS PALLIDUS FOR GENERALIZED DYSTONIA IN GM1 TYPE 3 GANGLIOSIDOSIS." Neurosurgery 59, no. 6 (December 1, 2006): E1340. http://dx.doi.org/10.1227/01.neu.0000245620.24603.1b.

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Abstract OBJECTIVE GM1 Type 3 gangliosidosis is a lysosomal storage disorder for which no specific treatment is available. It is characterized by progressive generalized dystonia, which is refractory to pharmacological treatment and results in severe disability and life-threatening complications. We performed bilateral pallidal stimulation in a patient with GM1 gangliosidosis and report the 12-month postoperative course. CLINICAL PRESENTATION A 24-year old woman presented with genetically confirmed GM1 gangliosidosis, resulting in severe progressive generalized dystonia. INTERVENTION Leads were implanted bilaterally into the internal part of the globus pallidus under stereotactic guidance. At follow-up visits, both the patient and the neurologists who performed the assessment were unaware of whether the neurostimulator was on or off. The patient was videotaped with a standardized protocol and scored by an independent expert. CONCLUSION After 1 year of follow-up, double-blind comparison of the patient's status with and without neurostimulation showed a 20% improvement, with a significant functional benefit, but no change in disease progression. Although further studies are needed to evaluate this therapeutic approach, this report suggests that pallidal stimulation might be a promising treatment for dystonia caused by GM1 Type 3 gangliosidosis.

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Takeuchi, Masaru, Katsuhiro Tokutake, Keita Watanabe, Naoyuki Ito, Tadayoshi Aoyama, Sota Saeki, Shigeru Kurimoto, Hitoshi Hirata, and Yasuhisa Hasegawa. "A Wirelessly Powered 4-Channel Neurostimulator for Reconstructing Walking Trajectory." Sensors 22, no. 19 (September 22, 2022): 7198. http://dx.doi.org/10.3390/s22197198.

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A wirelessly powered four-channel neurostimulator was developed for applying selective Functional Electrical Stimulation (FES) to four peripheral nerves to control the ankle and knee joints of a rat. The power of the neurostimulator was wirelessly supplied from a transmitter device, and the four nerves were connected to the receiver device, which controlled the ankle and knee joints in the rat. The receiver device had functions to detect the frequency of the transmitter signal from the transmitter coil. The stimulation site of the nerves was selected according to the frequency of the transmitter signal. The rat toe position was controlled by changing the angles of the ankle and knee joints. The joint angles were controlled by the stimulation current applied to each nerve independently. The stimulation currents were adjusted by the Proportional Integral Differential (PID) and feed-forward control method through a visual feedback control system, and the walking trajectory of a rat’s hind leg was reconstructed. This study contributes to controlling the multiple joints of a leg and reconstructing functional motions such as walking using the robotic control technology.

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Röderer, M., and A. Donderer. "Bradykarde Herzrhythmusstörung bei einem Patienten mit implantiertem Neurostimulator (SCS)." Der Notarzt 20, no. 5 (October 2004): 181–82. http://dx.doi.org/10.1055/s-2003-814971.

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De Lima, J. A., and A. S. Cordeiro. "A low-cost neurostimulator with accurate pulsed-current control." IEEE Transactions on Biomedical Engineering 49, no. 5 (May 2002): 497–500. http://dx.doi.org/10.1109/10.995689.

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Lee, Seunghyun, Jonghoek Kim, and Sanghoek Kim. "Power Link Optimization for a Neurostimulator in Nasal Cavity." International Journal of Antennas and Propagation 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/9096217.

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This paper examines system optimization for wirelessly powering a small implant embedded in tissue. For a given small receiver in a multilayer tissue model, the transmitter is abstracted as a sheet of tangential current density for which the optimal distribution is analytically found. This proposes a new design methodology for wireless power transfer systems. That is, from the optimal current distribution, the maximum achievable efficiency is derived first. Next, various design parameters are determined to achieve the target efficiency. Based on this design methodology, a centimeter-sized neurostimulator inside the nasal cavity is demonstrated. For this centimeter-sized implant, the optimal distribution resembles that of a coil source and the optimal frequency is around 15 MHz. While the existing solution showed an efficiency of about 0.3 percent, the proposed system could enhance the efficiency fivefold.

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Meyring, Kristina, Adrian Zehnder, Ralph A. Schmid, and Gregor J. Kocher. "Thoracic surgery in patients with an implanted neurostimulator device." Interactive CardioVascular and Thoracic Surgery 25, no. 4 (June 29, 2017): 667–68. http://dx.doi.org/10.1093/icvts/ivx213.

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Dommel, N. B., Y. T. Wong, T. Lehmann, C. W. Dodds, N. H. Lovell, and G. J. Suaning. "A CMOS retinal neurostimulator capable of focussed, simultaneous stimulation." Journal of Neural Engineering 6, no. 3 (May 20, 2009): 035006. http://dx.doi.org/10.1088/1741-2560/6/3/035006.

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