Search results for: intra-cranial self stimulation

Authors: Annika Skansberg

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Electronic cigarettes (e-cigarettes) use vapor to deliver nicotine, have recently become popular, especially amongst adolescents. Because of this, the FDA has decided to regulate e-cigarettes, and therefore would like to determine the abuse liability of the products compared to traditional nicotine products. This will allow them to determine the impact of regulating them on public health and shape the decisions they make when creating new laws. This study assessed the abuse liability of Aroma E-juice Dark Honey Tobacco compared to nicotine using an animal model. This e-liquid contains minor alkaloids that may increase abuse liability compared to nicotine alone. The abuse liability of nicotine alone and e-juice liquid were compared in rats using intracranial self-stimulation (ICSS) thresholds. E-liquid had less aversive effects at high nicotine doses in the ICSS model, suggesting that the minor alkaloids in the e-liquid allow users to use higher doses without experiencing the negative effects felt when using high doses of nicotine alone. This finding could mean that e-cigarettes have a higher abuse liability than nicotine alone, but more research is needed before this can be concluded. These findings are useful in observing the abuse liability of e-cigarettes and will help inform the FDA while regulating these products.

Keywords: electronic cigarettes, intra-cranial self stimulation, abuse liability, anhedonia

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Authors: M. Alam, P. Seshaiyer

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The rupture predictability of intracranial aneurysm is one of the most important parameters for physicians in surgical treatment. As most of the intracranial aneurysms are asymptomatic, still the rupture potential of both symptomatic and asymptomatic lesions is relatively unknown. Moreover, an intracranial aneurysm constrained by a nerve tissue might be a common scenario for a physician to deal with during the treatment process. Here, we perform a computational modeling of nerve tissue constrained intracranial saccular aneurysm to show a protective role of constrained tissue on the aneurysm. A comparative parametric study of the model also performs taking long constraint, medium constraint, short constraint, point contact, narrow neck aneurysm, wide neck aneurysm as parameters for the analysis. Results show that contact constraint aneurysm generates less stress near the fundus compared to no constraint aneurysm, hence works as a protective wall for the aneurysm not to be ruptured.

Keywords: rupture potential, intracranial saccular aneurysm, anisotropic hyper-elastic material, finite element analysis

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Authors: R. Ruslee, H. Gollee

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Functional electrical stimulation (FES) is a commonly used technique in rehabilitation and often associated with rapid muscle fatigue which becomes the limiting factor in its applications. The objective of this study is to investigate the effects on the onset of fatigue of conventional synchronous stimulation, as well as asynchronous stimulation that mimic voluntary muscle activation targeting different motor units which are activated sequentially or randomly via multiple pairs of stimulation electrodes. We investigate three different approaches with various electrode configurations, as well as different patterns of stimulation applied to the gastrocnemius muscle: Conventional Synchronous Stimulation (CSS), Asynchronous Sequential Stimulation (ASS) and Asynchronous Random Stimulation (ARS). Stimulation was applied repeatedly for 300 ms followed by 700 ms of no-stimulation with 40 Hz effective frequency for all protocols. Ten able-bodied volunteers (28±3 years old) participated in this study. As fatigue indicators, we focused on the analysis of Normalized Fatigue Index (NFI), Fatigue Time Interval (FTI) and pre-post Twitch-Tetanus Ratio (ΔTTR). The results demonstrated that ASS and ARS give higher NFI and longer FTI confirming less fatigue for asynchronous stimulation. In addition, ASS and ARS resulted in higher ΔTTR than conventional CSS. In this study, we proposed a randomly distributed stimulation method for the application of FES and investigated its suitability for reducing muscle fatigue compared to previously applied methods. The results validated that asynchronous stimulation reduces fatigue, and indicates that random stimulation may improve fatigue resistance in some conditions.

Keywords: asynchronous stimulation, electrode configuration, functional electrical stimulation (FES), muscle fatigue, pattern stimulation, random stimulation, sequential stimulation, synchronous stimulation

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Authors: Dilesh Mogre, Jitendra Toravi, Saurabh Joshi, Prutha Deshpande, Aishwarya Kura

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In earlier days of technology, it was not possible to understand the nature of complex biomedical problems and were only left to clinical postulations. With advancement in science today, we have tools like Finite Element Modelling and simulation to solve complex biomedical problems. This paper presents how ANSYS WORKBENCH can be used to study deformation of pneumatized sphenoid bone caused by increased intracranial pressure. Intracranial pressure refers to the pressure inside the skull. The increase in the pressure above the normal range of 15mmhg can lead to serious conditions due to developed stresses and deformation. One of the areas where the deformation is suspected to occur is Sphenoid Bone. Moreover, the varying degree of pneumatization increases the complexity of the conditions. It is necessary to study deformation patterns on pneumatized sphenoid bone model at elevated intracranial pressure. Finite Element Analysis plays a major role in developing and analyzing model and give quantitative results.

Keywords: intracranial pressure, pneumatized sphenoid bone, deformation, finite element analysis

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Authors: Hsiao-Wen Tsai

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Motor vehicle accident is the first cause of head injury in the world; severe head injury cases may cause conscious disturbance and death. This is a report about a case of a young adult patient suffering from motor vehicle accident leading to severe head injury who passed through three time surgical procedures, and his mother (who is the informal caregiver). This case was followed from 28th January to 15th February 2011 by using Gordon’s 11 functional health patterns. Patient’s cognitive-perceptual and self-perception-self-concept patterns were altered. Anxiety was also noted on his informal caregiver due to patients’ condition. During the intensive care period, maintaining patient’s vital signs and cerebral perfusion pressure were essential to avoid secondary neuronal injury. Multi-sensory stimulation, caring accompanying, supporting, listening and encouraging patient’s family involved in patient care were very important to reduce informal caregiver anxiety. Finally, the patient consciousness improved from GCS 4 to GCS 11 before discharging from ICU. Patient’s primary informal caregiver, his mother, also showed anxiety improvement. This is was successful case with traumatic brain injury recovered from coma.

Keywords: anxiety, multi-sensory stimulation, reduce intracranial adaptive capacity, traumatic brain injury

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Authors: Shi-Uk Lee, Chae Young Lim

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Objective: The aim of this study was to evaluate the changes of lumbar deep muscle thickness and cross-sectional area using ultrasonography with magnetic stimulation. Methods: To evaluate the changes of lumbar deep muscle by using magnetic stimulation, 12 healthy volunteers (39.6±10.0 yrs) without low back pain during 3 months participated in this study. All the participants were checked with X-ray and electrophysiologic study to confirm that they had no problems with their back. Magnetic stimulation was done on the L5 and S1 root with figure-eight coil as previous study. To confirm the proper motor root stimulation, the surface electrode was put on the tibialis anterior (L5) and abductor hallucis muscles (S1) and the hot spots of magnetic stimulation were found with 50% of maximal magnetic stimulation and determined the stimulation threshold lowering the magnetic intensity by 5%. Ultrasonography was used to assess the changes of L5 and S1 lumbar multifidus (superficial and deep) cross-sectional area and thickness with maximal magnetic stimulation. Cross-sectional area (CSA) and thickness was evaluated with image acquisition program, ImageJ software (National Institute of Healthy, USA). Wilcoxon signed-rank was used to compare outcomes between before and after stimulations. Results: The mean minimal threshold was 29.6±3.8% of maximal stimulation intensity. With minimal magnetic stimulation, thickness of L5 and S1 deep multifidus (DM) were increased from 1.25±0.20, 1.42±0.23 cm to 1.40±0.27, 1.56±0.34 cm, respectively (P=0.005, P=0.003). CSA of L5 and S1 DM were also increased from 2.26±0.18, 1.40±0.26 cm2 to 2.37±0.18, 1.56±0.34 cm2, respectively (P=0.002, P=0.002). However, thickness of L5 and S1 superficial multifidus (SM) were not changed from 1.92±0.21, 2.04±0.20 cm to 1.91±0.33, 1.96±0.33 cm (P=0.211, P=0.199) and CSA of L5 and S1 were also not changed from 4.29±0.53, 5.48±0.32 cm2 to 4.42±0.42, 5.64±0.38 cm2. With maximal magnetic stimulation, thickness of L5, S1 of DM and SM were increased (L5 DM, 1.29±0.26, 1.46±0.27 cm, P=0.028; L5 SM, 2.01±0.42, 2.24±0.39 cm, P=0.005; S1 DM, 1.29±0.19, 1.67±0.29 P=0.002; S1 SM, 1.90±0.36, 2.30±0.36, P=0.002). CSA of L5, S1 of DM and SM were also increased (all P values were 0.002). Conclusions: Deep lumbar muscles could be stimulated with lumbar motor root magnetic stimulation. With minimal stimulation, thickness and CSA of lumbosacral deep multifidus were increased in this study. Further studies are needed to confirm whether the similar results in chronic low back pain patients are represented. Lumbar magnetic stimulation might have strengthening effect of deep lumbar muscles with no discomfort.

Keywords: magnetic stimulation, lumbar multifidus, strengthening, ultrasonography

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Authors: Trevor E. Davis, Isaac Cassar, Yi-Kai Lo, Wentai Liu

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This study models the use of transcutaneous electrical nerve stimulation on skin with a disk electrode in order to simulate tissue damage. The current density distribution above a disk electrode is known to be a dynamic and non-uniform quantity that is intensified at the edges of the disk. The non-uniformity is subject to change through using various electrode geometries or stimulation methods. One of these methods known as edge-retarded stimulation has shown to reduce this edge enhancement. Though progress has been made in modeling the behavior of a disk electrode, little has been done to test the validity of these models in simulating the actual heat transfer from the electrode. This simulation uses finite element software to couple the injection of current from a disk electrode to heat transfer described by the Pennesbioheat transfer equation. An example application of this model is studying an experimental form of stimulation, known as edge-retarded stimulation. The edge-retarded stimulation method will reduce the current density at the edges of the electrode. It is hypothesized that reducing the current density edge enhancement effect will, in turn, reduce temperature change and tissue damage at the edges of these electrodes. This study tests this hypothesis as a demonstration of the capabilities of this model. The edge-retarded stimulation proved to be safer after this simulation. It is shown that temperature change and the fraction of tissue necrosis is much greater in the square wave stimulation. These results bring implications for changes of procedures in transcutaneous electrical nerve stimulation and transcutaneous spinal cord stimulation as well.

Keywords: bioheat transfer, electrode, neuroprosthetics, TENS, transcutaneous stimulation

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Authors: Naim Izet Kajtazi

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Context: Frequently, the cause of raised intracranial pressure remains unresolved and rarely is related to spinal tumors, moreover less to spinal medulloblastoma without primary brain focus. Process: An 18-year-old woman had a 3-month history of headaches and impaired vision. Neurological examination revealed bilateral sixth cranial nerve palsies with bilateral papilloedema of grade III. No focal brain or spine lesion was found on imaging. Consecutive lumbar punctures showed high opening pressure and subsequent increasing protein level. The meningeal biopsy was negative. At one point, she developed an increasing headache, vomiting and back pain. Spine MRI showed diffuse nodular leptomeningeal enhancement with the largest nodule at T6–T7. Malignant cells were detected in cerebrospinal fluid. She underwent laminectomy with excisional biopsy, and pathology showed medulloblastoma WHO grade IV. Outcome: She was treated with chemotherapy and craniospinal irradiation and made a good recovery. Relevance: Primary spinal leptomeningeal medulloblastoma is extremely rare, especially without primary brain focus, but may cause increased intracranial pressure, even in the early microscopic phases, and it should be considered in the differential diagnosis if conventional and aggressive treatment of idiopathic intracranial hypertension fails. We assume that arachnoiditis from tumor seeding caused increased intracranial pressure. Appropriate neurosurgical intervention and surgical biopsy are mandated if a suspicious lesion is detected. Consider proper rescreening of the whole neuroaxis in refractory cases of intracranial hypertension.

Keywords: CNS infection, IIH, headache, primary spinal leptomeningeal medulloblastoma

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Authors: Diego Luján Villarreal

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Visual prostheses are designed to repair some eyesight in patients blinded by photoreceptor diseases, such as retinitis pigmentosa (RP) and age-related macular degeneration (AMD). Electrode-to-cell proximity has drawn attention due to its implications on secure single-localized stimulation. Yet, few techniques are available for understanding the relationship between the number of cells activated and the current injection. We propose an answering technique by solving the governing equation for time-dependent electrical currents using finite element discretization to obtain the volume of stimulation.

Keywords: visual prosthetic devices, volume for stimulation, FEM discretization, 3D simulation

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Authors: Seung Chul Lee, Jooyeong Kim, Ki Ok Ahn, Juok Park

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Background: Injuries caused by motorcycle crashes are one of the major public health burdens leading to high mortality, functional disability. The risk of death among motorcyclists is 30 times greater than that among car drivers, with head injuries the leading cause of death. The motorcycle helmet is crucial protective equipment for motorcyclists. Aims: This study aimed to measure the protective effect of motorcycle helmet use on intracranial injury and mortality and to compare the preventive effect in drivers and passengers. Methods: This is a cross-sessional study based on the Emergency Department (ED)–based Injury In-depth Surveillance (EDIIS) database from 23 EDs in Korea. All of the trauma patients injured in motorcycle crashes between January 1, 2013 and December 31, 2016 were eligible, excluding cases with unknown helmet use and outcomes. The primary and secondary outcomes were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs) of helmet use for study outcomes after adjusting for potential confounders. Using interaction models, we compared the protective effect of helmet use on outcomes across driving status (driver and passenger). Results: Among 17,791 eligible patients, 10,668 (60.0%) patients were wearing helmets at the time of the crash, 2,128 (12.0%) patients had intracranial injuries and 331 (1.9%) patients had in-hospital death. 16,381 (92.1%) patients were drivers and 1410 (7.9%) patients were passengers. 62.6% of drivers and 29.1% of passengers were wearing helmets at the time of the crash. Compared to un-helmeted group, the helmeted group was less likely to have an intracranial injury(8.0% vs. 17.9%, AOR: 0.43 (0.39-0.48)) and in-hospital mortality (1.0% vs. 3.2%, AOR: 0.29 (0.22-0.37)).In the interaction model, AORs (95% CIs) of helmet use for intracranial injury were 0.42 (0.38-0.47) in drivers and 0.61(0.41-0.90) in passengers, respectively. There was a significant preventive effect of helmet use on in-hospital mortality in drivers (AOR: 0.26(0.21–0.34)). Discussion and conclusions: Wearing helmets in motorcycle crashes reduced intracranial injuries and in-hospital mortality. The preventive effect of motorcycle helmet use on intracranial injury was stronger in drivers than in passengers. There was a significant preventive effect of helmet use on in-hospital mortality in driver but not in passengers. Public health efforts to increase motorcycle helmet use are needed to reduce health burden from injuries caused by motorcycle crashes.

Keywords: intracranial injury, helmet, mortality, motorcycle crashes

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Authors: Yinjun Tu, Qiang Fang, Glenn I. Matthews, Shuenn-Yuh Lee

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This paper reports an efficient and rigorous self-adaptive stimulus artifacts removal approach for a mixed surface EMG (Electromyography) and stimulus signal during muscle stimulation. The recording of EMG and the stimulation of muscles were performing simultaneously. It is difficult to generate muscle fatigue feature from the mixed signal, which can be further used in closed loop system. A self-adaptive method is proposed in this paper, the stimulation frequency was calculated and verified firstly. Then, a mask was created based on this stimulation frequency to remove the undesired stimulus. 20 EMG signal recordings were analyzed, and the ANOVA (analysis of variance) approach illustrated that the decreasing trend of median power frequencies was successfully generated from the 'cleaned' EMG signal.

Keywords: EMG, FES, stimulus artefacts, self-adaptive

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Authors: Geetanjali Saggar

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Background: Partial hearing loss is the inability to hear effectively as a normal hearing individual whose hearing threshold is 20 dB or better in both ears. Individuals with partial hearing loss may benefit from non-invasive electrical stimulation as a method of therapy and possible intervention. Objective: The project aims to assess and relate the efficacy of electrical stimulation on individuals with partial hearing loss. The study's goal was to evaluate the different sorts of non-invasive electrical stimulation in tinnitus and hearing loss in order to build the framework for future research. Method: In this pilot study, a total of five patients of age group above 50 years were selected with partial hearing loss. The electrical modality of Repetitive Transcranial Magnetic Stimulation (RTMS) was used among the patients and was evaluated using gold questionnaires- HHIA and APHAB for hearing at intervals of 0-7-14 days. The statistical data was analyzed by SPSS software-16. Results: There were not much significant changes in the hearing of the patients when non-invasive electrical modality was applied as an intervention in the partial hearing loss condition. However, there was minimal change in the daily functioning of the patient with the application of intervention. Conclusion: This study concluded that non-invasive electrical stimulation had minimal to no effect on the partial hearing of the patients.

Keywords: non-invasive, hearing loss, transcranial magnetic stimulation, partial deafness, transcranial direct current stimulation, tinnitus

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Authors: S. Shafiee Ardestani, A. Najafi, N. Valizadeh, E. Payani, H. Karimian

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Objectives: Treatment of mild traumatic brain injury in emergency ward patients with any type of traumatic intracranial hemorrhage is flexible. The aim of this study is to assess the clinical outcomes of mild traumatic brain injury patients who had acute traumatic intracranial hemorrhage on initial emergency ward neuroimaging. Materials-Methods: From March 2011 to November 2012 in a retrospective cohort study we enrolled emergency ward patients with mild traumatic brain injury with Glasgow Coma Scale (GCS) scores of 14 or 15 and who had stable vital signs. Patients who had any type of intracranial hemorrhage on first head CT and repeat head CT within 24 hours were included. Patients with initial GCS < 14, injury > 24 hours old, pregnancy, concomitant non-minor injuries, and coagulopathy were excluded. Primary endpoints were neurosurgical procedures and/or death and for discharged patients, return to the emergency ward during one week. Results: Among 755 patients who were referred to the emergency ward and underwent two head CTs during first 24 hours, 302 (40%) were included. The median interval between CT scans was 6 hours (ranging 4 to 8 hours). Consequently, 135 (45%) patients had subarachnoid hemorrhage, 124 (41%) patients had subdural hemorrhage, 15 (5%) patients had epidural hemorrhage, 28 (9%) patients had cerebral contusions, and 54 (18%) patients had intra-parenchymal hemorrhage. Six of 302 patients died within 15 days of injury. 200 patients (66%) have been discharged from the emergency ward, 25 (12%) of whom returned to the emergency ward after one week. Conclusion: Discharge of the head trauma patients after a repeat head CT and brief period of observation in the emergency ward lead to early discharge of mild traumatic brain injury patients with traumatic ICH without adverse events.

Keywords: clinical outcomes, emergency ward, mild traumatic intracranial hemorrhage, Glasgow Coma Scale (GCS)

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Authors: Meet Bhatia

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Well stimulation and heavy oil recovery continue to be a hot topic in our industry, particularly with formation damage and viscous oil respectively. Cyclic steam injection has been recognised for most of the operations related to heavy oil recovery. However, the cost of implementation is high and operation is time-consuming, moreover most of the viscous oil reservoirs such as oil sands, Bitumen deposits and oil shales require additional treatment of well stimulation. The use of hydrogen peroxide can efficiently replace the cyclic steam injection process as it can be used for both well stimulation and heavy oil recovery simultaneously. The decomposition of Hydrogen peroxide produces oxygen, superheated steam and heat. The increase in temperature causes clays to shrink, destroy carbonates and remove emulsion thus it can efficiently remove the near wellbore damage. The paper includes mechanisms, parameters to be considered and the challenges during the treatment for the effective hydrogen peroxide injection for both conventional and heavy oil reservoirs.

Keywords: hydrogen peroxide, well stimulation, heavy oil recovery, steam injection

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Authors: Ana Lucia Molina

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Transcranial magnetic stimulation (TMS) is a non-invasive neuromodulation technique for the investigation and modulation of cortical excitability in humans. The modulation of the processing of different cortical areas can result in several areas for rehabilitation, showing great potential in the treatment of motor disorders. In the human brain, the supplementary motor area (SMA) is involved in the control of the pelvic floor muscles (MAP), where dysfunctions of these muscles can lead to urinary incontinence. Peripheral magnetic stimulation, specifically sacral magnetic stimulation, has been used as a safe and effective treatment option for patients with lower urinary tract dysfunction. A systematic literature review was carried out (Pubmed, Medline and Google academic database) without a time limit using the keywords: "transcranial magnetic stimulation", "sacral neuromodulation", and "urinary incontinence", where 11 articles attended to the inclusion criteria. Results: Thirteen articles were selected. Magnetic stimulation is a non-invasive neuromodulation technique widely used in the evaluation of cortical areas and their respective peripheral areas, as well as in the treatment of lesions of brain origin. With regard to pelvic-perineal disorders, repetitive transcranial stimulation showed significant effects in controlling urinary incontinence, as well as sacral peripheral magnetic stimulation, in addition to exerting the potential to restore bladder sphincter function. Conclusion: Data from the literature suggest that both transcranial stimulation and peripheral stimulation are non-invasive references that can be promising and effective means of treatment in pelvic and perineal disorders. More prospective and randomized studies on a larger scale are needed, adapting the most appropriate and resolving parameters.

Keywords: urinary incontinence, non-invasive neuromodulation, sacral neuromodulation, transcranial magnetic stimulation.

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Authors: Mohamed Abdelrahman Abdalla

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Apart from their function in producing CSF, the brain ventricles have been recognized as the mere remnant of the embryological neural tube with no clear role. The lack of proper definition of the function of the brain ventricles and the central spinal canal has made it difficult to ascertain the pathophysiology of its different disease conditions or to treat them. This study aims to review the simple physics that could explain the basic function of the CNS ventricular system and to suggest new ways of approaching its pathology. There are probably more physical factors to consider than only the pressure. Monro-Killie hypothesis focuses on volume and subsequently pressure to direct our surgical management in different disease conditions. However, the enlarged volume of the ventricles in normal pressure hydrocephalus does not move any blood or brain outside the skull. Also, in idiopathic intracranial hypertension, the very high intracranial pressure rarely causes brain herniation. On this note, the continuum of the intracranial cavity with the spinal canal makes it a whole unit and hence the defect in the theory. In this study, adding different factors to the equation like brain and CSF density and positions of the brain in space, in addition to the volume and pressure, aims to identify how the ventricles are important in the CNS homeostasis. In addition, increasing the variables that we analyze to treat different CSF pathological conditions should increase our understanding and hence accuracy of treatment of such conditions.

Keywords: communicating hydrocephalus, functions of the ventricles, idiopathic intracranial hypertension physics of CSF

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Authors: A. Guerrero, A. Leon, S. Munoz, M. Sandoval

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The addition of solvent to cyclic steam stimulation is done in order to reduce the solvent-vapor ratio at late stages of the process, the moment in which this relationship increases significantly. The study of the use of naphtha in addition to the cyclic steam stimulation has been mainly oriented to the effect it achieves on the incremental recovery compared to the application of steam only. However, the effect of naphtha on the reactivity of crude oil components under conditions of cyclic steam stimulation or if its effect is the only dilution has not yet been considered, to author’s best knowledge. The present study aims to evaluate and understand the effect of naphtha and the conditions of cyclic steam stimulation, on the remaining composition of the improved oil, as well as the main mechanisms present in the heavy crude - naphtha interaction. Tests were carried out with the system solvent (naphtha)-oil (12.5° API, 4216 cP @ 40° C)- steam, in a batch micro-reactor, under conditions of cyclic steam stimulation (250-300 °C, 400 psi). The characterization of the samples obtained was carried out by MALDI-TOF MS (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry) and NMR (Nuclear Magnetic Resonance) techniques. The results indicate that there is a rearrangement of the microstructure of asphaltenes, resulting in a decrease in these and an increase in lighter components such as resins.

Keywords: composition change, cyclic steam stimulation, interaction mechanism, naphtha

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Authors: Izadpanh Shaghayegh, Adli Fateme

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Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms, including tremors, bradykinesia, rigidity, and freezing of gait (FOG), which arise from degeneration of the basal ganglia. While pharmacological treatments, particularly dopaminergic therapies, remain the primary approach for managing PD, their long-term effectiveness diminishes due to complications such as dyskinesia and motor fluctuations. Deep brain stimulation (DBS) has emerged as an alternative for symptom management but remains invasive, costly, and associated with significant risks. In light of these challenges, non-invasive brain stimulation (NIBS) techniques are gaining attention as promising alternatives for treating PD. These methods, including transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and microwave brain stimulation (MBS), offer advantages such as reduced risk and non-invasiveness while providing targeted modulation of brain activity. Recent innovations, such as hemispherical antenna arrays for focused stimulation and advanced signal patterns like high-frequency prime harmonics and temporal interference (TI), have further enhanced the precision and efficacy of NIBS. These techniques have shown potential in modulating neuronal excitability, improving gait, and reducing motor symptoms in PD patients, with some approaches demonstrating effectiveness in treating FOG. Despite promising results, continued research is necessary to refine these technologies, optimize treatment protocols, and evaluate their long-term impact on PD progression. This review highlights recent advances in non-invasive brain stimulation for PD and discusses their potential as adjunctive therapies for managing motor symptoms and improving quality of life in PD patients.

Keywords: Parkinson’s disease, non-invasive brain stimulation, deep brain stimulation, transcranial magnetic stimulation, transcranial direct current stimulation, freezing of gait, microwave brain stimulation, neuromodulation

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Authors: Camelia Porey, Binaya Kumar Jaiswal

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BACKGROUND: Antiphospholipid antibody (APLA) syndrome is an autoimmune disorder predisposing to thrombotic complications affecting CNS either by arterial vasooclusion or venous thrombosis. Cerebral venous sinus thrombosis (CVST) secondarily causes raised intracranial pressure (ICP). However, intracranial hypertension without evidence of CVST is a rare entity. Here we present two cases of elevated ICP with absence of identifiable CVST. CASE SUMMARY: Case 1, 28-year female had a 2 months history of holocranial headache followed by bilateral painless vision loss reaching lack of light perception over 20 days. CSF opening pressure was elevated. Fundoscopy showed bilateral grade 4 papilledema. MRI revealed a partially empty sella with bilateral optic nerve tortuosity. Idiopathic intracranial hypertension (IIH) was diagnosed. With acetazolamide, there was complete resolution of the clinical and radiological abnormalities. 5 months later she presented with acute onset right-sided hemiparesis. MRI was suggestive of acute left MCA infarct.MR venogram was normal. APLA came positive with high titres of Anticardiolipin and Beta 2 glycoprotein both IgG and IgM. Case 2, 23-year female, presented with headache and diplopia of 2 months duration. CSF pressure was elevated and Grade 3 papilledema was seen. MRI showed bilateral optic nerve hyperintensities with nerve head protrusion with normal MRV. APLA profile showed elevated beta 2 glycoprotein IgG and IgA. CONCLUSION: This is an important non thrombotic complication of APLA syndrome and requires further large-scale study for insight into the pathogenesis and early recognition to avoid future complications.

Keywords: APLA syndrome, idiopathic intracranial hypertension, MR venogram, papilledema

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Authors: E. Nakamachi, K. Matsumoto, K. Yamamoto, Y. Morita, H. Sakamoto

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In recently, electromagnetic and mechanical stimulations have been recognized as the effective extracellular environment stimulation technique to enhance the defected peripheral nerve tissue regeneration. In this study, we developed a new hybrid bioreactor by adopting 50 Hz uniform alternative current (AC) magnetic stimulation and 4% strain mechanical stimulation. The guide tube for nerve regeneration is mesh structured tube made of biodegradable polymer, such as polylatic acid (PLA). However, when neural damage is large, there is a possibility that peripheral nerve undergoes necrosis. So it is quite important to accelerate the nerve tissue regeneration by achieving enhancement of nerve axonal extension rate. Therefore, we try to design and fabricate the system that can simultaneously load the uniform AC magnetic field stimulation and the stretch stimulation to cells for enhancement of nerve axonal extension. Next, we evaluated systems performance and the effectiveness of each stimulation for rat adrenal pheochromocytoma cells (PC12). First, we designed and fabricated the uniform AC magnetic field system and the stretch stimulation system. For the AC magnetic stimulation system, we focused on the use of pole piece structure to carry out in-situ microscopic observation. We designed an optimum pole piece structure using the magnetic field finite element analyses and the response surface methodology. We fabricated the uniform AC magnetic field stimulation system as a bio-reactor by adopting analytically determined design specifications. We measured magnetic flux density that is generated by the uniform AC magnetic field stimulation system. We confirmed that measurement values show good agreement with analytical results, where the uniform magnetic field was observed. Second, we fabricated the cyclic stretch stimulation device under the conditions of particular strains, where the chamber was made of polyoxymethylene (POM). We measured strains in the PC12 cell culture region to confirm the uniform strain. We found slightly different values from the target strain. Finally, we concluded that these differences were allowable in this mechanical stimulation system. We evaluated the effectiveness of each stimulation to enhance the nerve axonal extension using PC12. We confirmed that the average axonal extension length of PC12 under the uniform AC magnetic stimulation was increased by 16 % at 96 h in our bio-reactor. We could not confirm that the axonal extension enhancement under the stretch stimulation condition, where we found the exfoliating of cells. Further, the hybrid stimulation enhanced the axonal extension. Because the magnetic stimulation inhibits the exfoliating of cells. Finally, we concluded that the enhancement of PC12 axonal extension is due to the magnetic stimulation rather than the mechanical stimulation. Finally, we confirmed that the effectiveness of the uniform AC magnetic field stimulation for the nerve axonal extension using PC12 cells.

Keywords: nerve cell PC12, axonal extension, nerve regeneration, electromagnetic-mechanical stimulation, bioreactor

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Authors: Rahaf Mandura

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Background: Idiopathic intracranial hypertension (IIH) is a disorder with elevated intracranial pressure (ICP) more than 250 mm H₂O, without evidence of meningeal inflammation, space-occupying lesion, or venous thrombosis. The aim of this research is to study the clinical profile, evaluation, management, and visual outcome in a hospital-based population of IIH cases in Jeddah. Methodology: This is a retrospective observational study that included the medical records of all patients referred to neuro-ophthalmology service for evaluation of papilledema. The medical records have been reviewed from October 2018 to February 2020 at Jeddah Eye Hospital (JEH), Saudi Arabia. A total of fifty-one patients presented with papilledema in the studied period. Forty-seven patients met our inclusion criteria and were included in the study. Results: Most of the patients were females (43, 91.5%) with a mean age of presentation of 30.83±11.40 years. The most common presenting symptom was headache (40 patients, 85.1%), followed by transient visual obscuration (20 patients, 42.6%), and reduced visual acuity (15 patients, 31.9%). All 47 patients were started on medical treatment with oral acetazolamide with four patients (8.5%) shifted to topiramate because of the lack of response or intolerance to acetazolamide while four patients (8.5%) underwent lumbar-peritoneal shunt because of inadequate control of the disease despite the treatment with medical therapy. For both eyes, the change in visual acuity across all assessment points was statistically significant. Nevertheless, there were no significant changes in the visual field findings among all of the compared assessment points. Conclusion: The present study has shown that IIH-related papilledema is common in young female patients with headaches, transient visual obscurations and reduced visual acuity. Those are the commonest symptoms in our IIH population. Medical treatment of IIH is significantly efficacious and should be considered in order to enhance the prognosis of IIH-related complications. Therefore, the visual status should be frequently monitored for these patients.

Keywords: idiopathic intracranial hypertension, intracranial hypertension, papilledema, headache

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Authors: Sabiha Sahin, Kursad Bora Carman, Coskun Yarar

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Introduction: Measuring the diameter of the optic nerve sheath is a noninvasive and easy to use imaging technique to predict intracranial pressure in children and adults. The aim was to measure the diameter of the optic nerve sheath in pediatric head trauma. Methods: The study group consisted of 40 children with healthy and 40 patients with head trauma. Transorbital sonographic measurement of the optic nerve sheath diameter was performed. Conclusion: The mean diameters of the optic nerve sheath of right and left eyes were 0.408 ± 0.064 mm and 0.417 ± 0.065 mm, respectively, in the trauma group. These results were higher in patients than in control group. There was a negative correlation between optic nerve sheath diameters and Glasgow Coma Scales in patients with head trauma (p < 0.05). There was a positive correlation between optic nerve sheath diameters and positive CT findings, systolic blood pressure in patients with head trauma. The clinical status of the patients at admission, blood pH and lactate level were related to the optic nerve sheath diameter. Conclusion: Measuring the diameter of the optic nerve sheath is not an invasive technique and can be easily used to predict increased intracranial pressure and to prevent secondary brain injury.

Keywords: head trauma, intracranial pressure, optic nerve, sonography

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Authors: Jalil Qoulizadeh, Hasan Sadeghi

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Brain waves are electrical wave patterns that are produced in the human brain. Knowing these waves and activating them can have a positive effect on brain function and ultimately create an ideal life. The brain has the ability to produce waves from 0.1 to above 65 Hz. (The Beta One device produces exactly these waves) This is because it is said that the waves produced by the Beta One device exactly match the waves produced by the brain. The function and method of this device is based on the magnetic stimulation of the brain. The technology used in the design and producƟon of this device works in a way to strengthen and improve the frequencies of brain waves with a pre-defined algorithm according to the type of requested function, so that the person can access the expected functions in life activities. to perform better. The effect of this field on neurons and their stimulation: In order to evaluate the effect of this field created by the device, on the neurons, the main tests are by conducting electroencephalography before and after stimulation and comparing these two baselines by qEEG or quantitative electroencephalography method using paired t-test in 39 subjects. It confirms the significant effect of this field on the change of electrical activity recorded after 30 minutes of stimulation in all subjects. The Beta One device is able to induce the appropriate pattern of the expected functions in a soft and effective way to the brain in a healthy and effective way (exactly in accordance with the harmony of brain waves), the process of brain activities first to a normal state and then to a powerful one. Production of inexpensive neuroscience equipment (compared to existing rTMS equipment) Magnetic brain stimulation for clinics - homes - factories and companies - professional sports clubs.

Keywords: stimulation, brain, waves, betaOne

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Authors: Hyeon Su Kim, Sungjin Park, Hae Ryung Chang, Hae Rim Jung, Young Zoo Ahn, Yon Hui Kim, Seungyoon Nam

Abstract:

Ependymoma, one of the most common parenchymal spinal cord tumor, represents 3-6% of all CNS tumor. Especially intracranial ependymomas, which are more frequent in childhood, have a more poor prognosis and more malignant than spinal ependymomas. Although there are growing needs to understand pathogenesis, detailed molecular understanding of pathogenesis remains to be explored. A cancer cell is composed of complex signaling pathway networks, and identifying interaction between genes and/or proteins are crucial for understanding these pathways. Therefore, we explored each ependymoma in terms of differential expressed genes and signaling networks. We used Microsoft Excel™ to manipulate microarray data gathered from NCBI’s GEO Database. To analyze and visualize signaling network, we used web-based PATHOME algorithm and Cytoscape. We show HOX family and NEFL are down-regulated but SCL family is up-regulated in cerebrum and posterior fossa cancers over a spinal cancer, and JAK/STAT signaling pathway and Chemokine signaling pathway are significantly different in the both intracranial ependymoma comparing to spinal ependymoma. We are considering there may be an age-dependent mechanism under different histological pathogenesis. We annotated mutation data of each gene subsequently in order to find potential target genes.

Keywords: systems biology, ependymoma, deg, network analysis

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Authors: Ana Bermudez de Castro Muela, Xiomara Santos Salas, Silvia Cayon Somacarrera

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The aim of this review is to explain what is the intracranial hypotension and its main causes, and also to approach to the diagnostic management in the different clinical situations, understanding radiological findings, and physiopathological substrate. An approach to the diagnostic management is presented: what are the guidelines to follow, the different tests available, and the typical findings. We review the myelo-CT and myelo-RM studies in patients with suspected CSF fistula or hypotension of unknown cause during the last 10 years in three centers. Signs of intracranial hypotension (subdural hygromas/hematomas, pachymeningeal enhancement, venous sinus engorgement, pituitary hyperemia, and lowering of the brain) that are evident in baseline CT and MRI are also sought. The intracranial hypotension is defined as a lower opening pressure of 6 cmH₂O. It is a relatively rare disorder with an annual incidence of 5 per 100.000, with a female to male ratio 2:1. The clinical features it’s an orthostatic headache, which is defined as development or aggravation of headache when patients move from a supine to an upright position and disappear or typically relieve after lay down. The etiology is a decrease in the amount of cerebrospinal fluid (CSF), usually by loss of it, either spontaneous or secondary (post-traumatic, post-surgical, systemic disease, post-lumbar puncture etc.) and rhinorrhea and/or otorrhea may exist. The pathophysiological mechanisms of hypotension and CSF hypertension are interrelated, as a situation of hypertension may lead to hypotension secondary to spontaneous CSF leakage. The diagnostic management of intracranial hypotension in our center includes, in the case of being spontaneous and without rhinorrhea and/or otorrhea and according to necessity, a range of available tests, which will be performed from less to more complex: cerebral CT, cerebral MRI and spine without contrast and CT/MRI with intrathecal contrast. If we are in a situation of intracranial hypotension with the presence of rhinorrhea/otorrhea, a sample can be obtained for the detection of b2-transferrin, which is found in the CSF physiologically, as well as sinus CT and cerebral MRI including constructive interference steady state (CISS) sequences. If necessary, cisternography studies are performed to locate the exact point of leakage. It is important to emphasize the significance of myelo-CT / MRI to establish the diagnosis and location of CSF leak, which is indispensable for therapeutic planning (whether surgical or not) in patients with more than one lesion or doubts in the baseline tests.

Keywords: cerebrospinal fluid, neuroradiology brain, magnetic resonance imaging, fistula

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Authors: Mahdi Akhbardeh

Abstract:

Synchronization of neuronal firing is a hallmark of several neurological diseases. Recently, stimulation techniques have been developed which make it possible to desynchronize oscillatory neuronal activity in a mild and effective way, without suppressing the neurons' firing. As yet, these techniques are being used to establish demand-controlled deep brain stimulation (DBS) techniques for the therapy of movement disorders like severe Parkinson's disease or essential tremor. We here present a first conceptualization suggesting that the nucleus accumbens is a promising target for the standard, that is, permanent high-frequency, DBS in patients with severe and chronic obsessive-compulsive disorder (OCD). In addition, we explain how demand-controlled DBS techniques may be applied to the therapy of OCD in those cases that are refractory to behavioral therapies and pharmacological treatment.

Keywords: stereotactic neurosurgery, deep brain stimulation, obsessive-compulsive disorder, phase resetting

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Authors: Alexandre H. Okano, Pedro M. D. Agrícola, Daniel G. Da S. Machado, Luiz I. Do N. Neto, Luiz F. Farias Junior, Paulo H. D. Nascimento, Rickson C. Mesquita, John F. Araujo, Eduardo B. Fontes, Hassan M. Elsangedy, Shinsuke Shimojo, Li M. Li

Abstract:

The prefrontal cortex is involved in the reward system and the insular cortex integrates the afferent inputs arriving from the body’ systems and turns into feelings. Therefore, modulating neuronal activity in these regions may change individuals’ perception in a given situation such as exercise. We tested whether transcranial direct current stimulation (tDCS) change cerebral oxygenation and pleasure during exercise. Fourteen volunteer healthy adult men were assessed into five different sessions. First, subjects underwent to a maximum incremental test on a cycle ergometer. Then, subjects were randomly assigned to a transcranial direct current stimulation (2mA for 15 min) intervention in a cross over design in four different conditions: anode and cathode electrodes on T3 and Fp2 targeting the insular cortex, and Fpz and F4 targeting prefrontal cortex, respectively; and their respective sham. These sessions were followed by 30 min of moderate intensity exercise. Brain oxygenation was measured in prefrontal cortex with a near infrared spectroscopy. Perceived exertion and pleasure were also measured during exercise. The asymmetry in prefrontal cortex oxygenation before the stimulation decreased only when it was applied over this region which did not occur after insular cortex or sham stimulation. Furthermore, pleasure was maintained during exercise only after prefrontal cortex stimulation (P > 0.7), while there was a decrease throughout exercise (P < 0.03) during the other conditions. We conclude that tDCS over the prefrontal cortex changes brain oxygenation in ventromedial prefrontal cortex and maintains perceived pleasure during exercise. Therefore, this technique might be used to enhance effective responses related to exercise.

Keywords: affect, brain stimulation, dopamine neuromodulation, pleasure, reward, transcranial direct current stimulation

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Authors: Firoozeh Ghazanfari, Kourosh Amraei, Parisa Poorabadi

Abstract:

Mild cognitive impairment is one of the neurocognitive disorders that go beyond age-related decline in cognitive functions, but in fact, it is not so severe which affects daily activities. This study aimed to investigate and compare the effectiveness of treatment with cranial electrical stimulation, brain training and their double combination on the language and verbal fluency of the elderly with mild cognitive impairment. This is a single-subject method with comparative intervention designs. Four patients with a definitive diagnosis of mild cognitive impairment by a psychiatrist were selected via purposive and convenience sampling method. Addenbrooke's Cognitive Examination Scale (2017) was used to assess language and verbal fluency. Two groups were formed with different order of cranial electrical stimulation treatment, brain training by pencil and paper method and their double combination, and two patients were randomly replaced in each group. The arrangement of the first group included cranial electrical stimulation, brain training, double combination and the second group included double combination, cranial electrical stimulation and brain training, respectively. Treatment plan included: A1, B, A2, C, A3, D, A4, where electrical stimulation treatment was given in ten 30-minutes sessions (5 mA and frequency of 0.5-500 Hz) and brain training in ten 30-minutes sessions. Each baseline lasted four weeks. Patients in first group who first received cranial electrical stimulation treatment showed a higher percentage of improvement in the language and verbal fluency subscale of Addenbrooke's Cognitive Examination in comparison to patients of the second group. Based on the results, it seems that cranial electrical stimulation with its effect on neurotransmitters and brain blood flow, especially in the brain stem, may prepare the brain at the neurochemical and molecular level for a better effectiveness of brain training at the behavioral level, and the selective treatment of electrical stimulation solitude in the first place may be more effective than combining it with paper-pencil brain training.

Keywords: cranial electrical stimulation, treatment, brain training, verbal fluency, cognitive impairment

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Authors: Jana Stepanovska, Roman Matejka, Jozef Rosina, Marta Vandrovcova, Lucie Bacakova

Abstract:

The aim of this study was to develop a system for mechanical and also electrical stimulation controlling in vitro osteogenesis under conditions more similar to the in vivo bone microenvironment than traditional static cultivation, which would achieve good adhesion, growth and other specific behaviors of osteogenic cells in cultures. An engineered culture system for mechanical stimulation of the mesenchymal stem cells on the charged surface was designed. The bioreactor allows efficient mechanical loading inducing an electrical response and perfusion of the culture chamber with seeded cells. The mesenchymal stem cells were seeded to specific charged materials, like polarized hydroxyapatite (Hap) or other materials with piezoelectric and ferroelectric features, to create electrical potentials for stimulating of the cells. The material of the matrix was TiNb alloy designed for these purposes, and it was covered by BaTiO3 film, like a kind of piezoelectric material. The process of mechanical stimulation inducing electrical response is controlled by measuring electrical potential in the chamber. It was performed a series of experiments, where the cells were seeded, perfused and stimulated up to 48 hours under different conditions, especially pressure and perfusion. The analysis of the proteins expression was done, which demonstrated the effective mechanical and electrical stimulation. The experiments demonstrated effective stimulation of the cells in comparison with the static culture. This work was supported by the Ministry of Health, grant No. 15-29153A and the Grant Agency of the Czech Republic grant No. GA15-01558S.

Keywords: charged surface, dynamic cultivation, electrical stimulation, ferroelectric layers, mechanical stimulation, piezoelectric layers

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Authors: Mahtab Baghaei, Seyed Mahmoud Tabatabaei

Abstract:

Aim & Background: Electrical stimulation of transcranial direct current is considered one of the treatment methods for mental disorders. The aim of this study was to evaluate the effectiveness of transcranial electrical stimulation on the delta, theta, alpha, beta and systolic and diastolic blood pressure in patients with generalized anxiety disorder. Materials and Methods: The present study was a double-blind intervention with a pre-test and post-test design on people with generalized anxiety disorder in Tabriz in 1400. In this study, 30 patients with generalized anxiety disorder were selected by purposive sampling method based on the criteria specified in DSM-5 and randomly divided into an experimental group (n = 15) and a control group (n = 15). The experimental group received two sessions of 30 minutes of electrical stimulation of transcranial direct current with an intensity of 2 mA in the area of the lateral dorsal prefrontal cortex, and the control group also received artificial stimulation. Results: The results showed that transcranial electrical stimulation reduces delta and theta waves and increases beta and alpha brain waves in the experimental group. On the other hand, this method also showed a significant decrease in systolic and diastolic blood pressure in these patients (p <0.01). Conclusion: The results show that transcranial electrical stimulation has a statistically significant effect on brain waves and blood pressure, and this non-invasive method can be used as one of the treatment methods in people with generalized anxiety disorder.

Keywords: transcranial direct current electrical stimulation, brain waves, systolic blood pressure, diastolic blood pressure

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