Search results for: somatosensory stimulation

Authors: Jiewei Li, Hongyan Cui, Chunqi Chang, Yong Hu

Abstract:

It was expected to benefit patient with hemiparesis after stroke by extensive arm rehabilitation, to partially regain forearm and hand function. This paper propose a robotic rehabilitation arm in assisting the hemiparetic patient to learn new ways of using and moving their weak arms. In this study, the robotic arm was driven by a somatosensory stimulated brain computer interface (BCI), which is a new modality BCI. The use of somatosensory stimulation is not only an input for BCI, but also a electrical stimulation for treatment of hemiparesis to strengthen the arm and improve its range of motion. A trial of this robotic rehabilitation arm was performed in a stroke patient with pure motor hemiparesis. The initial trial showed a promising result from the patient with great motivation and function improvement. It suggests that robotic rehabilitation arm driven by somatosensory BCI can enhance the rehabilitation performance and progress for hemiparetic patients after stroke.

Keywords: robotic rehabilitation arm, brain computer interface (BCI), hemiparesis, stroke, somatosensory stimulation

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Authors: Sarah Sayed El- Tawab, Emmanuel Kamal Azix Saba

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Objectives: Somatosensory blink reflex (SBR) is an eye blink response obtained from electrical stimulation of peripheral nerves or skin area of the body. It has been studied in various neurological diseases as well as among healthy subjects in different population. We designed this study to detect SBR positivity in patients with facial palsy and patients with post facial syndrome, to relate the facial palsy severity and the presence of SBR, and to associate between trigeminal BR changes and SBR positivity in peripheral facial palsy patients. Methods: 50 patients with peripheral facial palsy and post-facial syndrome 31 age and gender matched healthy volunteers were enrolled to this study. Facial motor conduction studies, trigeminal BR, and SBR were studied in all. Results: SBR was elicited in 67.7% of normal subjects, in 68% of PFS group, and in 32% of PFP group. On the non-paralytic side SBR was found in 28% by paralyzed side stimulation and in 24% by healthy side stimulation among PFP patients. For PFS group SBR was found on the non- paralytic side in 48%. Bilateral SBR elicitability was higher than its unilateral elicitability. Conclusion: Increased brainstem interneurons excitability is not essential to generate SBR. The hypothetical sensory-motor gating mechanism is responsible for SBR generation.

Keywords: somatosensory evoked blink reflex, post facial syndrome, blink reflex, enchanced gain

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Authors: Tariq Ali Gujar, Anita Hökelmann

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Postural balance plays essential role throughout life in daily activities. Somatosensory, visual and vestibular inputs play the fundamental role in maintaining body equilibrium to balance the posture. The aim of this study was to find out electroencephalography (EEG) responses during balance activity of young people during Sensory Organization Balance Test. The outcome of this study will help to create the fitness and neurorehabilitation plan. 25 young people (25 ± 3.1 years) have been analyzed on Balance Master NeuroCom® with the coupling of Brain Vision 32 electrode wireless EEG system during the Sensory Organization Test. From the results it has been found that the balance score of samples is significantly higher under the influence of somatosensory input as compared to visual and vestibular input (p < 0.05). The EEG between somatosensory and visual input to balance the posture showed significantly higher (p < 0.05) alpha and beta activities during somatosensory input in somatosensory, attention and visual functions of the cortex whereas executive and motor functions of the cerebral cortex showed significantly higher (p < 0.05) alpha EEG activity during the visual input. The results suggest that somatosensory and attention function of the cerebral cortex has alpha and beta activity, respectively high during somatosensory and vestibular input in maintaining balance. In patients with balance impairments both physical and cognitive training, including neurofeedback will be helpful to improve balance abilities.

Keywords: balance, electroencephalography activity, somatosensory, visual, vestibular

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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: I-Han Hsiao, Chun-Ping Huang, Ching-Liang Hsieh, Yi-Wen Lin

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Epilepsy is chronic brain disorder that results in the sporadic occurrence of spontaneous seizures in the temporal lobe, cerebral cortex, and hippocampus. Clinical antiepileptic medicines are often ineffective or little benefits in the small amount of patients and usually initiate severe side effects. This inflammation contributes to enhanced neuronal excitability and the onset of epilepsy. Auricular electric-stimulation (AES) can increase parasympathetic activity and stimulate the solitary tract nucleus to induce the cholinergic anti-inflammatory pathway. Furthermore, it may be a therapeutic strategy for the treatment of epilepsy. In the present study, we want to investigate the effects of AES on inflammatory mediators in kainic acid (KA)-induced epileptic seizure rats. Experimental KA injection increased expression of TLR-2 pathway associated inflammatory mediators, were further reduced by either 2Hz or 15 Hz AES in the prefrontal cortex, hippocampus, and somatosensory cortex. We suggest that AES can successfully control the epileptic seizure by down-regulation of inflammation signaling pathway.

Keywords: auricular electric-stimulation, epileptic seizures, anti-inflammation

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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: 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: 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: Eglal Y. Ali, Smita Rao, Anat Lubetzky, Wen Ling

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Background: Postural abnormalities, rigidity, clumsiness, and frequent falls are common among children with autism spectrum disorders (ASD). The central nervous system’s ability to process all reliable sensory inputs (weighting) and disregard potentially perturbing sensory input (reweighting) is critical for successfully maintaining standing postural control. This study examined how sensory inputs (visual and somatosensory) are weighted and reweighted to maintain standing postural control in children with ASD compared with typically developing (TD) children. Subjects: Forty (20 (TD) and 20 ASD) children and adolescents participated in this study. The groups were matched for age, weight, and height. Participants had normal somatosensory (no somatosensory hypersensitivity), visual, and vestibular perception. Participants with ASD were categorized with severity level 1 according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and Social Responsiveness Scale. Methods: Using one force platform, the center of pressure (COP) was measured during quiet standing for 30 seconds, 3 times first standing on stable surface with eyes open (Condition 1), followed by randomization of the following 3 conditions: Condition 2 standing on stable surface with eyes closed, (visual input perturbed); Condition 3 standing on compliant foam surface with eyes open, (somatosensory input perturbed); and Condition 4 standing on compliant foam surface with eyes closed, (both visual and somatosensory inputs perturbed). Standing postural control was measured by three outcome measures: COP sway area, COP anterior-posterior (AP), and mediolateral (ML) path length (PL). A repeated measure mixed model Analysis of Variance was conducted to determine whether there was a significant difference between the two groups in the mean of the three outcome measures across the four conditions. Results: According to all three outcome measures, both groups showed a gradual increase in postural sway from condition 1 to condition 4. However, TD participants showed a larger postural sway than those with ASD. There was a significant main effect of condition on three outcome measures (p< 0.05). Only the COP AP PL showed a significant main effect of the group (p<0.05) and a significant group by condition interaction (p<0.05). In COP AP PL, TD participants showed a significant difference between condition 2 and the baseline (p<0.05), whereas the ASD group did not. This suggests that the ASD group did not weight visual input as much as the TD group. A significant difference between conditions for the ASD group was seen only when participants stood on foam regardless of the visual condition, suggesting that the ASD group relied more on the somatosensory inputs to maintain the standing postural control. Furthermore, the ASD group exhibited significantly smaller postural sway compared with TD participants during standing on the stable surface, whereas the postural sway of the ASD group was close to that of the TD group on foam. Conclusion: These results suggest that participants with high functioning ASD (level 1, no somatosensory hypersensitivity in ankles and feet) over-rely on somatosensory inputs and use a stiffening strategy for standing postural control. This deviation in the reweighting mechanism might explain the postural abnormalities mentioned above among children with ASD.

Keywords: autism spectrum disorders, postural sway, sensory weighting and reweighting, standing postural control

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Authors: Eglal Y. Ali, Smita Rao, Anat Lubetzky, Wen Ling

Abstract:

Background: Postural abnormalities, rigidity, clumsiness, and frequent falls are common among children with autism spectrum disorders (ASD). The central nervous system’s ability to process all reliable sensory inputs (weighting) and disregard potentially perturbing sensory input (reweighting) is critical for successfully maintaining standing postural control. This study examined how sensory inputs (visual and somatosensory) are weighted and reweighted to maintain standing postural control in children with ASD compared with typically developing (TD) children. Subjects: Forty (20 (TD) and 20 ASD) children and adolescents participated in this study. The groups were matched for age, weight, and height. Participants had normal somatosensory (no somatosensory hypersensitivity), visual, and vestibular perception. Participants with ASD were categorized with severity level 1 according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and Social Responsiveness Scale. Methods: Using one force platform, the center of pressure (COP) was measured during quiet standing for 30 seconds, 3 times first standing on stable surface with eyes open (Condition 1), followed by randomization of the following 3 conditions: Condition 2 standing on stable surface with eyes closed, (visual input perturbed); Condition 3 standing on a compliant foam surface with eyes open, (somatosensory input perturbed); and Condition 4 standing on a compliant foam surface with eyes closed, (both visual and somatosensory inputs perturbed). Standing postural control was measured by three outcome measures: COP sway area, COP anterior-posterior (AP), and mediolateral (ML) path length (PL). A repeated measure mixed model analysis of variance was conducted to determine whether there was a significant difference between the two groups in the mean of the three outcome measures across the four conditions. Results: According to all three outcome measures, both groups showed a gradual increase in postural sway from condition 1 to condition 4. However, TD participants showed a larger postural sway than those with ASD. There was a significant main effect of the condition on three outcome measures (p< 0.05). Only the COP AP PL showed a significant main effect of the group (p<0.05) and a significant group by condition interaction (p<0.05). In COP AP PL, TD participants showed a significant difference between condition 2 and the baseline (p<0.05), whereas the ASD group did not. This suggests that the ASD group did not weigh visual input as much as the TD group. A significant difference between conditions for the ASD group was seen only when participants stood on foam regardless of the visual condition, suggesting that the ASD group relied more on the somatosensory inputs to maintain the standing postural control. Furthermore, the ASD group exhibited significantly smaller postural sway compared with TD participants during standing on a stable surface, whereas the postural sway of the ASD group was close to that of the TD group on foam. Conclusion: These results suggest that participants with high-functioning ASD (level 1, no somatosensory hypersensitivity in ankles and feet) over-rely on somatosensory inputs and use a stiffening strategy for standing postural control. This deviation in the reweighting mechanism might explain the postural abnormalities mentioned above among children with ASD.

Keywords: autism spectrum disorders, postural sway, sensory weighting and reweighting, standing postural control

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Authors: Emmanuel Kamal Aziz Saba, Gihan Abd El-Lateif Younis El-Tantawi, Mohammed Hamdy Zahran, Ibrahim Khalil Ibrahim, Mohammed Abd El-Salam Shehata, Hussein Al-Moghazy Sultan, Medhat

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Pelvic floor electrophysiological tests are essential for assessment of patients with obstructed defecation. The present study was conducted to determine the different patterns of pelvic floor electrophysiology that are associated with obstructed defecation. The present cross sectional study included 25 patients with obstructed defecation. A control group of 20 apparently healthy subjects were included. All patients were subjected to history taking, clinical examination, proctosigmoidoscopy, lateral proctography (evacuation proctography), dynamic pelvic magnetic resonance imaging, anal manometry and electrophysiological studies. Electrophysiological studies were including pudendal nerve motor conduction study, pudendo-anal reflex, needle electromyography of external anal sphincter and puborectalis muscles, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The control group was subjected to electrophysiological studies which included pudendal nerve motor conduction study, pudendo-anal reflex, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The most common pelvic floor electrodiagnostic pattern characteristics of obstructed defecation was pudendal neuropathy, denervation and anismus of external anal sphincter and puborectalis with complete interference pattern of external anal sphincter and puborectalis at squeezing and cough and no localized defect in external anal sphincter. In conclusion, there were characteristic pelvic floor electrodiagnostic patterns associated with obstructed defecation.

Keywords: obstructed defecation, pudendal nerve terminal motor latency, pudendoanal reflex, sphincter electromyography

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Authors: Chang Ting, Wu Chun Kuan

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Wireless sensing technology is increasingly developed, in order to avoid caregiver neglect children in poor physiological condition, so there are more and more products into the wireless sensor-related technologies, in order to reduce the risk of infants. In view of this, the study will focus on Somatosensory detection wristbands Applied Research of Baby, and to explore through observation and literature, to find design criteria which conform baby products, as well as the advantages and disadvantages of existing products. This study will focus on 0-2 years of infant research and product design, to provide 2-3 new design concepts and products to identify weaknesses through the use of the actual product, further provide future baby wristbands design reference.

Keywords: infants, observation, design criteria, wireless sensing

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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: 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: 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: 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: Mahdi Akhbardeh

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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

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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

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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

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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

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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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Authors: Ji Hyung Park, Dong-Hyun Seo, Young-Jin Jung, Han Sung Kim

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The aim of this study is to evaluate the effects of the laser and partial vibration stimulation on the mice tibia with morphological characteristics. Twenty female C57BL/6 mice (12 weeks old) were used for the experiment. The study was carried out on four groups of animals each consisting of five mice. Four groups of mice were ovariectomized. Animals were scanned at 0 and 2 weeks after ovariectomy by using micro-computed tomography to estimate morphological characteristics of tibial trabecular bone. Morphological analysis showed that structural parameters of multi-stimuli group appear significantly better phase in BV/TV, BS/BV, Tb.Th, Tb.N, Tb.Sp, and Tb.pf than single stimulation groups. However, single stimulation groups didn’t show significant effect on tibia with Sham group. This study suggests that multi-stimuli may restrain the change as the degenerate phase on osteoporosis in the mice tibia.

Keywords: laser, partial vibration, osteoporosis, in-vivo micro-CT, mice

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Authors: Kira Merigan

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BACKGROUND- Fertility preservation (FP) measures are increasingly recognised as an important consideration for children and adolescents planned to undergo potentially damaging gonadotoxic therapy. Worldwide, there are very few documented cases of FP in young females by way of ovarian stimulation and oocyte cryopreservation.AIM – To report a case series of mature oocyte cryopreservation in 5post-pubertal adolescents aged 14-17 years old, with varied medical conditions requiring gonadotoxic treatment. SETTING-These cases took place via a multidisciplinary team approach at The Royal Children’s Hospital, a large tertiary centre in Melbourne, Australia. INTERVENTION– Ovarian stimulation and oocyte collection was performed as detailed in each case. RESULTS –Across the 5 patients, 3-28 oocytes were retrieved. We report pre-treatment workup, complications, and delays to treatment. CONCLUSION- Oocyte cryopreservation may be a safe alternative to ovarian tissue cryopreservation (OTC) in the adolescent population

Keywords: fertility preservation, adolescent, ovarian stimulation, oocyte cryopreservation

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Authors: Ehsan Kaviani, Azin Golmoradizade

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Introduction: Traditionally, tendons are considered to only contain tenocytes that are responsible for the maintenance, repair, and remodeling of tendons. Stem cells, which are termed tendon-derived stem cells, so this study we investigate the effect of transcranial direct current stimulation combined with swallowing training on post-stroke dysphagia. Methods: This review article is about effects of transcranial direct current stimulation (tDCS) on post-stroke dysphagia that were extracted from Science Direct, Pro quest, and Pub med Data Bases. 15 articles had been selected according to inclusion criteria from 2014 to 2019, and 6 of them had been deleted by exclusion criteria. Results: The results of our systematic review suggest that tDCS may represent a promising novel treatment for post-stroke dysphagia. However, to date, little is known about the optimal parameters of tDCS for relieving post-stroke dysphagia. Further studies are warranted to refine this promising intervention by exploring the optimal parameters of tDCS. Conclusion: anodal tDCS over the affected hemisphere may be as effective as cathodal tDCS on the unaffected hemisphere to enhance recovery after subacute ischemic stroke and anodal tdcs applied over the affected pharyngeal motor cortex can enhance the outcome of swallowing training in post-stroke dysphagia.

Keywords: dysphagia, stroke, cortical stimulation, transcranial direct current stimulation

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Authors: Aline M. Dantas, Alexander T. Sack, Elisabeth Bruggen, Peiran Jiao, Teresa Schuhmann

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Risk-taking behavior has been associated with the activity of specific prefrontal regions of the brain, namely the right dorsolateral prefrontal cortex (DLPFC) and the ventromedial prefrontal cortex (VMPFC). While the deactivation of the rDLPFC has been shown to lead to increased risk-taking behavior, the functional relationship between VMPFC activity and risk-taking behavior is yet to be clarified. Correlational evidence suggests that the VMPFC is involved in valuation processes that involve risky choices, but evidence on the functional relationship is lacking. Therefore, this study uses brain stimulation to investigate the role of the VMPFC during risk-taking behavior and replicate the current findings regarding the role of the rDLPFC in this same phenomenon. We used continuous theta-burst stimulation (cTBS) to inhibit either the VMPFC or DLPFC during the execution of the computerized Maastricht Gambling Task (MGT) in a within-subject design with 30 participants. We analyzed the effects of such stimulation on risk-taking behavior, participants’ choices of probabilities and average values, and response time. We hypothesized that, compared to sham stimulation, VMPFC inhibition leads to a reduction in risk-taking behavior by reducing the appeal to higher-value options and, consequently, the attractiveness of riskier options. Right DLPFC (rDLPFC) inhibition, on the other hand, should lead to an increase in risk-taking due to a reduction in cognitive control, confirming existent findings. Stimulation of both the rDLPFC and the VMPFC led to an increase in risk-taking behavior and an increase in the average value chosen after both rDLPFC and VMPFC stimulation compared to sham. No significant effect on chosen probabilities was found. A significant increase in response time was observed exclusively after rDLPFC stimulation. Our results indicate that inhibiting DLPFC and VMPFC separately leads to similar effects, increasing both risk-taking behavior and average value choices, which is likely due to the strong anatomical and functional interconnection of the VMPFC and rDLPFC.

Keywords: decision-making, risk-taking behavior, brain stimulation, TMS

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Authors: Pricillia Priska Sianita

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An aesthetic facial profile is one of the goals in Orthodontics treatment. However, this is not easily achieved, especially in patients with Class II Division 1 malocclusion who have the clinical characteristics of convex profile and significant skeletal discrepancy due to mandibular growth deficiency. Malocclusion with skeletal problems require proper treatment timing for growth stimulation, and it must be done in early age and in need of good cooperation from the patient. If this is not done and the patient has passed the growth period, the ideal treatment is orthognathic surgery which is more complicated and more painful. The growth stimulation of skeletal malocclusion requires a careful cephalometric evaluation ranging from diagnosis to determine the parts that require stimulation to post-treatment evaluation to see the success achieved through changes in the measurement of the skeletal parameters shown in the cephalometric analysis. This case report aims to describe skeletal changes cephalometrically that were achieved through orthodontic treatment in growing period. Material and method: Lateral Cephalograms, pre-treatment, and post-treatment of cases of Class II Division 1 malocclusion is selected from a collection of cephalometric radiographic in a private clinic. The Cephalogram is then traced and measured for the skeletal parameters. The result is noted as skeletal condition data of pre-treatment and post-treatment. Furthermore, superimposition is done to see the changes achieved. The results show that growth stimulation through orthodontic treatment can solve the skeletal problem of Class II Division 1 malocclusion and the skeletal changes that occur can be verified through cephalometric analysis. The skeletal changes have an impact on the improvement of patient's facial profile. To sum up, the treatment timing on a skeletal malocclusion is very important to obtain satisfactory results for the improvement of the aesthetic facial profile, and skeletal changes can be verified through cephalometric evaluation of pre- and post-treatment.

Keywords: cephalometric evaluation, class II division 1 malocclusion, growth stimulation, skeletal changes, skeletal problems

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Authors: E. Nakamachi, S. Tanaka, K. Yamamoto, Y. Morita

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In this study, we developed a three-dimensional (3D) direct current electric field (DCEF) stimulation bio-reactor for axonal outgrowth enhancement to generate the neural network of the central nervous system (CNS). By using our newly developed 3D DCEF stimulation bio-reactor, we cultured the rat pheochromocytoma cells (PC12) and investigated the effects on the axonal extension enhancement and network generation. Firstly, we designed and fabricated a 3D bio-reactor, which can load DCEF stimulation on PC12 cells embedded in the collagen gel as extracellular environment. The connection between the electrolyte and the medium using salt bridges for DCEF stimulation was introduced to avoid the cell death by the toxicity of metal ion. The distance between the salt bridges was adopted as the design variable to optimize a structure for uniform DCEF stimulation, where the finite element (FE) analyses results were used. Uniform DCEF strength and electric flux vector direction in the PC12 cells embedded in collagen gel were examined through measurements of the fabricated 3D bio-reactor chamber. Measurement results of DCEF strength in the bio-reactor showed a good agreement with FE results. In addition, the perfusion system was attached to maintain pH 7.2 ~ 7.6 of the medium because pH change was caused by DCEF stimulation loading. Secondly, we disseminated PC12 cells in collagen gel and carried out 3D culture. Finally, we measured the morphology of PC12 cell bodies and neurites by the multiphoton excitation fluorescence microscope (MPM). The effectiveness of DCEF stimulation to enhance the axonal outgrowth and the neural network generation was investigated. We confirmed that both an increase of mean axonal length and axogenesis rate of PC12, which have been exposed 5 mV/mm for 6 hours a day for 4 days in the bioreactor. We found following conclusions in our study. 1) Design and fabrication of DCEF stimulation bio-reactor capable of 3D culture nerve cell were completed. A uniform electric field strength of average value of 17 mV/mm within the 1.2% error range was confirmed by using FE analyses, after the structure determination through the optimization process. In addition, we attached a perfusion system capable of suppressing the pH change of the culture solution due to DCEF stimulation loading. 2) Evaluation of DCEF stimulation effects on PC12 cell activity was executed. The 3D culture of PC 12 was carried out adopting the embedding culture method using collagen gel as a scaffold for four days under the condition of 5.0 mV/mm and 10mV/mm. There was a significant effect on the enhancement of axonal extension, as 11.3% increase in an average length, and the increase of axogenesis rate. On the other hand, no effects on the orientation of axon against the DCEF flux direction was observed. Further, the network generation was enhanced to connect longer distance between the target neighbor cells by DCEF stimulation.

Keywords: PC12, DCEF stimulation, 3D bio-reactor, axonal extension, neural network generation

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Authors: Hyunsik Park

Abstract:

As the rate of cerebrovascular disease increases in old populations, the prevalence rate of vascular dementia would be expected. Therefore, authors designed this study to find out the possibility of somatosensory evoked potentials(SSEP) as a parameter for early diagnosis and prognosis prediction of vascular dementia in cortical vascular dementia patients. 21 patients who met the criteria for vascular dementia according to DSM-IV,ICD-10and NINDS-AIREN with the history of recent cognitive impairment, fluctuation progression, and neurologic deficit. We subdivided these patients into two groups; a mild dementia and a severe dementia groups by MMSE and CDR score; and analysed comparison between normal control group and patient control group who have been cerebrovascular attack(CVA) history without dementia by using N20 latency and amplitude of median nerve. In this study, mild dementia group showed significant differences on latency and amplitude with normal control group(p-value<0.05) except patient control group(p-value>0.05). Severe dementia group showed significant differences both normal control group and patient control group.(p-value<0.05, <001). Since no significant difference has founded between mild dementia group and patient control group, SSEP has limitation to use for early diagnosis test. However, the comparison between severe dementia group and others showed significant results which indicate SSEP can predict the prognosis of vascular dementia in cortical vascular dementia patients.

Keywords: SSEP, cortical vascular dementia, N20 latency, N20 amplitude

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