Effectiveness Of Stimulation Research Articles

Ultrasound Stimulation Modulates Microglia M1/M2 Polarization and Affects Hippocampal Proteomic Changes in a Mouse Model of Alzheimer's Disease.

The effectiveness of ultrasound stimulation in treating Alzheimer's disease (AD) has been reported in previous studies, but the underlying mechanisms remain unclear. This study investigated the effects of ultrasound stimulation on the proportion and function of microglia of different phenotypes, as well as on the levels of inflammatory factors. Additionally, it revealed the alterations in proteomic molecules in the mouse hippocampus following ultrasound stimulation treatment, aiming to uncover potential new molecular mechanisms. Ultrasound stimulation was used to stimulate the hippocampus for 30 min per day for 5 days in the ultrasound stimulation-treated group. Amyloid plaque deposition was measured using immunofluorescence staining. M1 and M2 type microglia were labeled using immunofluorescent double staining, and the ratio was calculated. The levels of Aβ42, IL-10, and TNF-α were determined using ELISA kits. The quantitative proteomics method was employed to explore molecular changes in hippocampal proteins. Ultrasound stimulation treatment reduced the average fluorescence intensity of amyloid plaques and the concentration of Aβ42. Compared to the AD group, ultrasound stimulation resulted in a 14% reduction in the proportion of M1 microglia and a 12% increase in the proportion of M2 microglia. The concentration of the anti-inflammatory factor IL-10 was significantly increased in the ultrasound stimulation-treated group. Proteomics analysis revealed 753 differentially expressed proteins between the ultrasound stimulation-treated and AD groups, with most being enriched in the oxidative phosphorylation pathway of mitochondria. Additionally, the activity of cytochrome c oxidase, involved in oxidative phosphorylation, was increased after ultrasound stimulation treatment. Ultrasound stimulation affects microglial polarization, reduces amyloid plaque load, and enhances levels of anti-inflammatory factors in APP/PS1 mice. Proteomics analysis reveals molecular changes in hippocampal proteins after ultrasound stimulation treatment. The mechanism behind ultrasound stimulation-induced modulation of microglial polarization may be related to changes in mitochondrial oxidative phosphorylation.

Effects of phrenic nerve magnetic stimulation on respiratory function in stroke patients: study protocol for a randomised controlled trial.

Respiratory dysfunction is a notable complication in stroke patients, in which the diaphragm, as the primary respiratory muscle, directly influences lung function. Repetitive peripheral magnetic stimulation (rPMS) is a new, non-invasive approach that is used to treat brain and nerve problems. Few studies have examined the effect of magnetic stimulation on the phrenic nerve, breathing and diaphragm in stroke patients. This study aims to assess the effect of magnetic phrenic nerve stimulation on respiratory muscle function and lung function in adults with stroke. The results of this study may provide a promising approach to managing respiratory dysfunction in stroke patients. This randomised controlled trial is designed to compare the effectiveness of bilateral magnetic phrenic nerve stimulation (rPMS) and conventional rehabilitation training in enhancing respiratory muscle strength, lung function indicators, diaphragmatic excursion and diaphragm thickness in patients with respiratory muscle weakness. Thirty patients admitted to the First Hospital of Fujian Medical University will be included in this study. Participants in the intervention group will undergo daily bilateral magnetic phrenic nerve stimulation for 2 weeks. Stimulation will be administered at a frequency of 25 Hz, with a pulse duration of 1.1 s and an inter-pulse interval of 5.9 s, for 5 days each week. Primary outcome measures will be assessed at baseline and after 2 weeks (end of the intervention) to evaluate the efficacy of rPMS compared with conventional rehabilitation techniques. Before commencing the study, all participants will receive a comprehensive explanation of the study procedures, including the assessments. They will also be provided informed consent forms for review, completion and signing. This study was approved by the Ethics Committee for Research at the First Affiliated Hospital of Fujian Medical University (No.: MRCTA, ECFAH of FMU [2021]641, dated 10 November 2023) (Appendix Ⅰ & Ⅱ). The trial protocol will strictly adhere to the Uniform Standards for Reporting of Trials (CONSORT) statement. The trial has been registered with the Chinese Clinical Trial Registry.Dissemination of individual findings for each participant will be available at the end of the study. The findings will be disseminated to different interest groups, participants or other patients with respiratory dysfunction through journal papers and/or conference presentations. The results of the primary trial will be submitted for publication in a peer-reviewed journal. ChiCTR2300075669, registered on 12 September 2023.

Comprehensive Evidence-Based Guidelines for Implantable Peripheral Nerve Stimulation (PNS) in the Management of Chronic Pain: From the American Society Of Interventional Pain Physicians (ASIPP)

BACKGROUND: Peripheral nerve stimulation (PNS) has been used for over 50 years to treat chronic pain by delivering electrical pulses through small electrodes placed near targeted peripheral nerves those outside the brain and spinal cord. Early PNS systems often required invasive neurosurgical procedures. However, since 2015, the Food and Drug Administration (FDA) approved percutaneously implanted PNS leads and neurostimulators offering a much less invasive, non-opioid option for managing recalcitrant chronic pain. The following FDA-cleared PNS systems are commercially available in the United States for the management of chronic, intractable pain: • Freedom® Peripheral Nerve Stimulator (PNS) System (Curonix LLC, 2017) • StimRouter® Neuromodulation System (Bioness, now Bioventus, 2015) • SPRINT® PNS System (SPR® Therapeutics, Inc., 2016) • Nalu™ Neurostimulation System (Nalu Medical Inc., 2019) • ReActiv8® Implantable Neurostimulation System (Mainstay Medical Limited, 2020) The American Society of Interventional Pain Physicians (ASIPP) has published evidence-based consensus guidelines for the application of PNS systems in managing chronic pain. OBJECTIVE: The guidelines aim to provide evidence-based recommendations for the utilization of peripheral nerve stimulation (PNS) in the management of moderate to severe chronic pain. These guidelines exclude field stimulation, or sacral nerve stimulation. METHODS: A multidisciplinary panel of experts in various medical and pharmaceutical fields, convened by ASIPP, reviewed the evidence, considered patient perspectives, and formulated recommendations for implantable peripheral nerve stimulation in chronic pain management. The methodology included developing key questions with evidence-based statements and recommendations. The grading of evidence and recommendations followed a modified approach described by ASIPP, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method, and the Agency for Healthcare Research and Quality (AHRQ) strength of recommendations methods. The evidence review includes existing guidelines, systematic reviews, comprehensive reviews, randomized controlled trials (RCTs), and observational studies on the effectiveness and safety of implantable peripheral nerve stimulation in managing chronic pain. The quality of published studies was assessed using appropriate instruments for systematic reviews, RCTs, and observational studies. In the development of consensus statements and guidelines, we used a modified Delphi technique, which has been described to minimize bias related to group interactions. Panelists without a primary conflict of interest voted to approve specific guideline statements. Each panelist could suggest edits to the guideline statement wording and could suggest additional qualifying remarks or comments as to the implementation of the guideline in clinical practice to achieve consensus and for inclusion in the final guidelines, each guideline statement required at least 80% agreement among eligible panel members without primary conflict of interest. RESULTS: A total of 31 authors participated in the development of these guidelines. Of these, 23 participated in the voting process. A total of 8 recommendations were developed. Overall, 100% acceptance was obtained for 8 of 8 items. Thus, with appropriate literature review, consensus-based statements were developed for implantable peripheral nerve stimulation in chronic pain management. In preparation of these guidelines, evidence synthesis included 7 systematic reviews, 8 RCTs, and 9 observational studies covering all PNS treatments. The evidence was developed using GRADE criteria or certainty of evidence, and qualitative synthesis based on the best available evidence. The evidence level and recommendations are as follows: For implantable peripheral nerve stimulation systems following a trial or selective lumbar medial branch stimulation without a trial, the evidence is Level III or fair with moderate certainty. Evidence Level: Fair; Strength of Recommendation: Moderate For temporary peripheral nerve stimulation for 60 days, the evidence is Level III or fair, with moderate certainty. Evidence Level: Fair; Strength of Recommendation: Moderate Based on the available evidence, it is our recommendation to expand the existing PNS related local coverage determination (LCD) to include craniofacial pain, phantom limb pain, and nociceptive pain in the lower back as present evidence shows Level III or fair with moderate certainty. LIMITATIONS: The primary limitation of these guidelines is the paucity of the available literature. CONCLUSION: These evidence-based guidelines support the use of implantable peripheral nerve stimulation leads and neurostimulators in patients with moderate to severe chronic pain refractory to two or more conservative treatments. These guidelines aim to optimize patient outcomes and promote health equity through the integration of PNS technology in clinical practice. KEY WORDS: Chronic pain, interventional techniques, peripheral neuropathy, peripheral neuropathic pain, peripheral nerve stimulation, selective lumbar medial branch stimulation DISCLAIMER: These guidelines do not constitute inflexible treatment recommendations. Clinicians are expected to establish a plan of care on a case-by-case basis, considering an individual patient’s medical condition, personal needs, and preferences, and the physician’s experience. Consequently, these guidelines do not represent a “standard of care.”

The effectiveness of transcranial direct current stimulation (tDCS) on information processing speed in children with intellectual disability

PurposeThe speed of information processing is known to play an important role in mental disorders; This study investigated the effect of the transcranial direct current stimulation on information processing speed in children with intellectual disabilities. MethodAn experimental design with a pretest- posttest control group was used. The study population consisted of 8- to 14-year-old children with intellectual disabilities attending special primary schools in Urmia, Iran. 36 children were randomly assigned to the experimental and control groups (18 for each group). The experimental group received 10 sessions of tDCS with anode positioned over the F3 electrode (left DLPFC) and cathode over F4 (right DLPFC) The control group did not receive any intervention. Trail Making Test (TMT) was used to assess information processing speed. Data were analyzed using MANCOVA. ResultsThe results revealed that tDCS led to a significant increase in information processing speed in the experimental group compared to the control group. ConclusionThis study demonstrates that tDCS applied to the dorsolateral prefrontal cortex (DLPFC) is effective in enhancing information processing speed in children with intellectual disabilities. These finding have important implications for the development of interventions aimed at improving cognitive functioning in children with intellectual disabilities.

Adolescent Reproductive Health: The Role Of Sex Education In Raising Awareness

The first stage of labor often takes a long time and causes discomfort for the mother, so methods are needed to accelerate it. This study aims to evaluate the effectiveness of microcontroller-based nipple stimulation in accelerating the labor process by stimulating the release of the hormone oxytocin which increases uterine contractions and accelerates cervical opening. Microcontroller technology is used to ensure the stimulation is done automatically and measured according to the mother's physiological needs. This study involved two groups, namely the group that received stimulation and the control group that did not receive stimulation. The results showed that the stimulated group experienced shorter labor times than the control group and were less likely to require medical interventions such as induction with drugs. Close monitoring is still required to ensure safety, especially regarding the risk of uterine hyperstimulation that may affect the condition of the mother and fetus. Further research is needed to test the long-term effectiveness and safety of this method before it is widely applied in obstetric practice. Based on the total library, 600 were identified and as many as 100 additional articles were identified. A total of 630 studies failed to meet the inclusion criteria and 70 articles were read in their entirety, so that as many as 11 publications were used as references. Microcontroller-based nipple stimulation offers an innovative solution that can improve the efficiency of labor while providing a better quality of health care.

The effectiveness of intramuscular dry needling stimulation in treating trigger points: A case series

Myofascial trigger points are a common presentation in clients with chronic spinal pain. Various techniques are used to manage trigger points and are considered a vital part of chronic spinal pain management. Reducing pain caused by trigger points may be effective in improving function. Case series can provide preliminary evidence and assist in feasibility assessment. The objective of this case series is to document the feasibility of intramuscular dry needling stimulation in managing trigger-point-induced chronic pain. Three individuals aged 35, 33, and 28 years presented to a private clinic with chief complaints of scapular region muscular pain, and their management is reported in this case series. Initial physical examination revealed tenderness over D6 and D8. There was a palpable para spinal muscle hypertonicity and reduced thoracic spine mobility to both sides in all the three clients. The presence of multiple trigger points bilateral to the spine indicated postural dysfunction, which altered pain on changing thoracic posture. Clients were treated with dry needling with intramuscular stimulation over trigger points, paraspinal muscle and inferior to scapula by a therapist trained in the technique. The frequency was kept at 1.5 Hz and intensity was as tolerated by the patient. Outcome measures were taken using VAS, RMDQ and digital inclinometer for thoracic spine rotation. Subject one reported a change of 22 mm in VAS after the first week and 40 mm in the fourth week. It also reported an improvement in mobility to both side rotations by 20 degrees in the first week and full towards the fourth week. Subject two and three improved VAS by 10 mm in week one and 35 mm towards the fourth week. Full mobility was achieved in the fourth week in both cases. RMDQ scores improved significantly in the three cases. The three cases demonstrate significant improvement in both symptoms and function based on outcome measures. This indicates the efficacy of treating thoracic spine myofascial trigger points with dry needling and intramuscular stimulation, but a large-scale study is recommended.

Mental Health Management Strategies in Pregnant Women and The Impact on Infant Health

The first stage of labor often takes a long time and causes discomfort for the mother, so methods are needed to accelerate it. This study aims to evaluate the effectiveness of microcontroller-based nipple stimulation in accelerating the labor process by stimulating the release of the hormone oxytocin which increases uterine contractions and accelerates cervical opening. Microcontroller technology is used to ensure the stimulation is done automatically and measured according to the mother's physiological needs. This study involved two groups, namely the group that received stimulation and the control group that did not receive stimulation. There are shortcomings in studies examining the effectiveness of interventions implemented at the organisational level in reducing stigma and improving mental health support. A variety of strategies can be used to address stigma, including proper education, awareness campaigns, and training for managers and employees on the importance of mental health. The development of inclusive policies and the provision of easy and non-discriminatory access to mental health services are essential. Consistent managerial support also plays a key role in creating a supportive work environment. Creating a positive and inclusive organizational culture will help companies improve employee mental health and well-being, while also increasing workforce productivity and retention. Reducing stigma and increasing support can create a healthier work environment, which ultimately supports individual development and the long-term success of the company.

Caloric Vestibular Stimulation Alleviates Cold Water Swimming Stress Induced Changes in BDNF and Haematological Parameters

Introduction: Stress is inevitable in daily life. Stress in long term has been implicated in the development of physical and neuronal disorders. Various studies have described the levels and role of BDNF in the brain following stress. Studies representing the changes in serum BDNF and wet weight of organs in stress are limited and controversial. Aim: The aim of the present study is to find the effect of stress on serum BDNF concentration, wet weight of selected organs, haematological parameters and to evaluate the effectiveness of caloric vestibular stimulation on stress-induced changes in these parameters. Methods and material: Male Wistar rats were exposed to cold water swimming stress for 14 days for a duration of 30 minutes per day. Serum corticosterone and serum BDNF were measured using the ELISA method. Weight of liver, spleen, thymus and lymph nodes were measured and their relation to body weight was calculated. Total RBC count, total WBC count, platelet count and haemoglobin concentration were analysed. Results: A statistically significant increase in serum corticosterone and BDNF was observed following stress. Liver weight, thymus weight and lymph nodes weight did not show any significant changes but spleen weight has reduced in the normal recovery group following stress. Total RBC count, total WBC count, platelet count and haemoglobin levels were significantly higher in the stress group. Caloric vestibular stimulation was effective in managing stress-induced changes in serum corticosterone, BDNF and spleen weight. Conclusion: Caloric vestibular stimulation is effective in restoring the stress-induced changes.

Effectiveness of Percutaneous Electrical Nerve Stimulation on Range of Motion, Pain Pressure Threshold in the Management of Myofascial Trigger Point: A Systemic Review

This review of randomized controlled trials sought to evaluate the efficacy of Percutaneous Electrical Nerve Stimulation (PENS) on range of motion, pain, and pain pressure threshold, as well as to investigate the specific factors influencing its effectiveness. The search for relevant studies published between 2017 and 2024 was conducted in PubMed, Scopus, The Cochrane Library, and the Physiotherapy Evidence Database. Fifteen studies met the inclusion criteria, with primary outcomes focusing on pain, range of motion, and quality of life. The findings indicate that percutaneous Electrical Nerve Stimulation (PENS) is effective in providing short-term pain relief, improving range of motion, and enhancing quality of life when compared to no intervention, sham, or placebo treatments. However, there is insufficient evidence regarding its impact on disability, analgesic medication intake, and sleep quality. In conclusion, while some evidence supports the short-term benefits of Percutaneous Electrical Nerve Stimulation (PENS), further high-quality randomized clinical trials with standardized procedures are necessary.

Repetitive transcranial magnetic stimulation as add-on therapy in persistent postural-perceptual dizziness

BackgroundThis study aims to evaluate the clinical effectiveness of repetitive transcranial magnetic stimulation (rTMS) when used as an add-on therapy for individuals with persistent postural-perceptual dizziness (PPPD). MethodsIn this randomized controlled, double-blind trial conducted at Shangluo Central Hospital, patients with PPPD diagnosed in the neurology departments were included. Participants were randomized into a rTMS treatment group and a control group in a 1:1 ratio by the randomized grouping method. Patients in both groups received conventional treatment, with the rTMS treatment group underwent daily rTMS sessions, whereas the control group received sham rTMS treatments following the same schedule. The effectiveness of the treatments was primarily assessed using the Dizziness Handicap Inventory (DHI), Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD), which measured symptoms of vertigo, anxiety, and depression at baseline, after two weeks, and at the end of four weeks. FindingsOf the 46 participants recruited, 2 were excluded due to contraindications, 22 were randomly assigned to the rTMS treatment group, and 22 were assigned to the control group. Ultimately, 2 withdrew for personal reasons, and data from 42 participants were included in the outcome analysis. HAMA, HAMD and DHI scores were significantly lower in the rTMS treatment group than in the control group after 4 weeks of treatment (p<0.05). A positive correlation was also observed between DHI scores and HAMA or HAMD scores. ConclusionsThis pilot study demonstrated that rTMS is a beneficial add-on therapy for patients with PPPD.

Mental Health In The Workplace: Overcoming Stigma And Increasing Support

The first stage of labor often takes a long time and causes discomfort for the mother, so methods are needed to accelerate it. This study aims to evaluate the effectiveness of microcontroller-based nipple stimulation in accelerating the labor process by stimulating the release of the hormone oxytocin which increases uterine contractions and accelerates cervical opening. Microcontroller technology is used to ensure the stimulation is done automatically and measured according to the mother's physiological needs. This study involved two groups, namely the group that received stimulation and the control group that did not receive stimulation. There are shortcomings in studies examining the effectiveness of interventions implemented at the organisational level in reducing stigma and improving mental health support. A variety of strategies can be used to address stigma, including proper education, awareness campaigns, and training for managers and employees on the importance of mental health. The development of inclusive policies and the provision of easy and non-discriminatory access to mental health services are essential. Consistent managerial support also plays a key role in creating a supportive work environment. Creating a positive and inclusive organizational culture will help companies improve employee mental health and well-being, while also increasing workforce productivity and retention. Reducing stigma and increasing support can create a healthier work environment, which ultimately supports individual development and the long-term success of the company.

Human foot cutaneous receptors function: clinical findings and prospects of using medical devices to stimulate mechanoreceptors in neurorehabilitation.

The effectiveness of the support stimulation of the mechanoreceptors of the feet has been first shown in space medicine. In space flight during support withdrawal with non-use of postural muscle, this method is a countermeasure against sensorimotor disorders. Later, it was applied in clinical practice as treatment of motor disorders after stroke, in Parkinson's disease, infantile cerebral palsy, neuropathies, and many others. The impact of such stimulation on motor control is due to spinal and supraspinal mechanisms, which are activated by creating an additional support afferent input through the plantar surface. Many studies confirmed the positive effect of support stimulation on motor control, but the protocols of such stimulation remain the subject of active discussion. This review includes (1) the features of sensitivity of the foot sole cutaneous afferents to the support mechanical stimuli, (2) data on spinal and supraspinal responses of the nervous system to support stimulation, and (3) the results of applying this approach in neurological practice via various techniques. Summarizing this information, the authors highlight the most promising ways and types of medical devices for foot support stimulation in neurology.

Transcutaneous Tibial Nerve Stimulation for Quality-of-Life Improvement and Sleep Deficiency in Women with Primary Dysmenorrhea: A Randomized Clinical Trial.

Background: Primary dysmenorrhea is a leading cause of chronic cyclic pelvic pain, contributing to a reduced quality of life and sleep disturbances in women. The objective of this study was to assess the effectiveness of transcutaneous tibial nerve stimulation (TTNS) in improving the quality of life, sleep, and overall health perceptions of participants compared to a control group of women with dysmenorrhea over short-term, medium-term, and long-term periods. Methods: A single-blind, controlled clinical trial was conducted, with participants randomly assigned to an experimental group (receiving TTNS) or a control group (receiving sham TTNS). Both groups underwent 12, weekly 30 min sessions using the NeuroTrac™ PelviTone electrostimulation device. Outcomes related to quality of life, sleep deficiency, and overall improvement were evaluated at three time points: short-term (post-treatment), medium-term (1-3 months), and long-term (6 months). Results: Of the 61 participants initially randomized (31 in the experimental group and 30 in the control group), 55 completed the study and were included in the final analysis. A statistically significant improvement was observed in the experimental group in both physical and mental health components, as measured by the SF-36v2® questionnaire, following 12 weeks of intervention, compared to the control group, persisting 6 months after the intervention. Additionally, statistically significant differences in overall improvement were noted between the two groups, as measured by the PGIC questionnaire at the end of treatment (p = 0.0103) and 6 months post-treatment (p = 0.0432). Conclusions: TTNS appears to be a safe and effective strategy for enhancing quality of life and overall health in women with PD, potentially reducing the reliance on pharmacological treatments or more invasive methods.

Effect Analysis of Early Rehabilitation Therapy Combined with Repetitive Transcranial Magnetic Stimulation on Postoperative Rehabilitation of Sports Knee Injury.

To analyze the effectiveness of combined early rehabilitation therapy and repetitive transcranial magnetic stimulation (rTMS) in the postoperative rehabilitation of patients with sports knee injuries (SKI). A total of 62 SKI patients from June 2021 to June 2022 were randomly selected by computer and divided into group A (31 cases, early rehabilitation therapy) and group B (31 cases, early rehabilitation therapy +rTMS) by numbered envelope method. The effects of the two groups were compared. After treatment, the pain frequency and pain intensity in group B were lower than in group A, while the completion of knee movements without significant pain, the degree of knee swelling, and the impact of the knee on activities were higher in group B than in group A; the Lysholm score and inflammatory factor indicators in group B were superior to those in group A (all P<0.05). The combination of early rehabilitation therapy and rTMS in postoperative rehabilitation of SKI patients has better effects on knee joint function and inflammation.

Copper‐infused zinc porphyrin supramolecular polymersomes for triple synergistic combat against wound bacterial biofilm infections

AbstractBacterial biofilm infections (BBI) on wound surfaces and implants pose a significant clinical challenge due to the impermeable nature of biofilms and obstacles in tissue repair. Traditional photothermal therapy (PTT) or chemodynamic therapy (CDT), whether used alone or in combination, often causes damage to surrounding normal tissues from high operating temperatures or elevated levels of reactive oxygen species, leading to unsatisfactory anti‐biofilm effects. This study introduces a novel copper ions loaded zinc porphyrin polymer vesicle (Cu‐PPS) that employs a triple synergistic approach involving PTT, CDT, and bacterial cuproptosis‐like death (BCD). Cu‐PPS exhibits exceptional photothermal efficiency of 51.06%, promoting the release of copper ions under photothermal stimulation, enhancing CDT and BCD effectiveness, and facilitating mature biofilm clearance and tissue repair. This approach achieves a bactericidal rate exceeding 99% and an anti‐biofilm rate of 93.32% in vitro and also excellent efficacy in treating BBI in vivo. This study presents an innovative therapeutic strategy for combating biofilm infections, addressing the challenges encountered in the clinical management of BBI.

Differing effectiveness of transcranial random noise stimulation and transcranial direct current stimulation for enhancing working memory in healthy individuals: a randomized controlled trial

BackgroundTranscranial direct current stimulation (tDCS) applied to the left dorsolateral prefrontal cortex (DLPFC) is a promising technique for enhancing working memory (WM) performance in healthy and psychiatric populations. However, limited information is available about the effectiveness of transcranial random noise stimulation (tRNS) applied to the left DLPFC on WM. This study investigated the effectiveness of tRNS on WM compared with that of tDCS, which has established functional evidence.MethodsThis randomized, double-blind, sham-controlled trial enrolled 120 healthy right-handed adults who were randomly allocated to four stimulation groups: tRNS + direct current (DC) offset, tRNS, tDCS, or sham. Each stimulus was placed over the left DLPFC and had a current intensity of 2 mA applied for 20 min during the dual n-back task. The dual n-back task was repeated thrice: pre-stimulation, during stimulation, and post-stimulation. The d-prime scores, and response times were calculated as the main outcome measures. A linear mixed model was created to identify the main effects and interactions between the groups and times, with the group and time as fixed effects, and baseline performance and the subject as a covariate and random effect, respectively. The relationships between the benefit of each stimulus and baseline WM performance were also examined.ResultsFor the d-prime score during stimulation, the tRNS group significantly performed better than the sham group at online assessment (β = 0.310, p = 0.001). In the relationships between the benefit of each stimulus and baseline WM performance, the tRNS group had significantly larger negative line slopes than the sham group for the d-prime score (β = −0.233, p = 0.038).ConclusionstRNS applied to the left DLPFC significantly improved WM performance and generated greater benefits for healthy individuals with lower WM performance. These findings highlight the potential utility of tRNS for enhancing WM performance in individuals with lower WM performance and contribute evidence for clinical application to patients with cognitive decline.Trial RegistrationThis study was registered in the University Hospital Medical Information Network Clinical Trial Registry in Japan (UMIN000047365) on April 1, 2022; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000054021.

Suppression of Visceral Nociception by Selective C-Fiber Transmission Block Using Temporal Interference Sinusoidal Stimulation.

Chronic visceral pain management remains challenging due to limitations in selective targeting of C-fiber nociceptors. This study investigates temporal interference stimulation (TIS) on dorsal root ganglia (DRG) as a novel approach for selective C-fiber transmission block. We employed (1) GCaMP6 recordings in mouse whole DRG using a flexible, transparent microelectrode array for visualizing L6 DRG neuron activation, (2) ex vivo single-fiber recordings to assess sinusoidal stimulation effects on peripheral nerve axons, (3) in vivo behavioral assessment measuring visceromotor responses (VMR) to colorectal distension in mice, including a TNBS-induced visceral hypersensitivity model, and (4) immunohistological analysis to evaluate immediate immune responses in DRG following TIS. We demonstrated that TIS (2000 Hz and 2020 Hz carrier frequencies) enabled tunable activation of L6 DRG neurons, with the focal region adjustable by altering stimulation amplitude ratios. Low-frequency (20-50 Hz) sinusoidal stimulation effectively blocked C-fiber and Aδ-fiber transmission while sparing fast-conducting A-fibers, with 20 Hz showing highest efficacy. TIS of L6 DRG reversibly suppressed VMR to colorectal distension in both control and TNBS-induced visceral hypersensitive mice. The blocking effect was fine-tunable by adjusting interfering stimulus signal amplitude ratios. No apparent immediate immune responses were observed in DRG following hours-long TIS. In conclusion, TIS on lumbosacral DRG demonstrates promise as a selective, tunable approach for managing chronic visceral pain by effectively blocking C-fiber transmission. This technique addresses limitations of current neuromodulation methods and offers potential for more targeted relief in chronic visceral pain conditions.

Tackling Anticancer Drug Resistance and Endosomal Escape in Aggressive Brain Tumors Using Bioelectronics.

Resistance mechanisms in brain tumors, such as medulloblastoma and glioblastoma, frequently involve the entrapment of chemotherapeutic agents within endosomes and the extracellular expulsion of drugs. These barriers to effective treatment are exacerbated in nanotechnology-based drug delivery systems, where therapeutic nanoparticles often remain confined within endosomes, thus diminishing their therapeutic efficacy. Addressing this challenge necessitates the development of novel strategies to enhance the efficiency of cancer therapies. This study tests the hypothesis that external electrical stimuli can modulate intracellular trafficking of chemotherapeutic drugs in common malignant brain tumors in children (medulloblastoma) and adults (glioblastoma) by using gold nanoparticles (GNPs). In our experiments, alternating current (AC) stimulation ranging from 1 kHz to 5 MHz and at a strength of 1 V/cm significantly reduced cell viability in drug-resistant medulloblastoma and enhanced delivery of GNPs in glioblastoma. Low-frequency AC resulted in a 50% increase in apoptosis compared to controls and an 8-fold increase in cell death in cisplatin-resistant medulloblastoma cells, accompanied by a substantial reduction in EC50 from 2.5 to 0.3 μM. Similarly, vincristine-resistant cells demonstrated a 4-fold enhancement in drug sensitivity. Furthermore, high-frequency AC facilitated a significant increase from 20 to 75% in the endosomal escape of GNPs in glioblastoma cells. These findings underscore the potential of AC to selectively disrupt cancer cell resistance mechanisms and bolster the efficacy of nanoparticle-based therapies. The results indicate the effectiveness of AC stimulation in circumventing the limitations inherent in current nanotechnology-based drug delivery systems but also illustrates its transformative potential for treating aggressive, drug-resistant brain tumors.

Effectiveness of Mirror Therapy, Electrical Stimulation, and CIMT in Restoring Upper Extremity Function after Stroke

Objective: This study aimed to compare the effectiveness of mirror therapy (MT), electrical stimulation (EMS) combined with MT, and Constraint-Induced Movement Therapy (CIMT) in improving upper extremity function among stroke survivors. Methodology: A randomized controlled trial was conducted involving n=45 stroke patients undergoing rehabilitation at Wah International Hospital. The inclusion criteria for the study required participants to be above 45 years of age, to have survived either an ischemic or haemorrhagic stroke, and to have at least 10° wrist extension. Participants were excluded if they had an implanted electrical device such as an artificial pacemaker, paresis instead of paralysis, hemiplegia due to causes other than ischemic or haemorrhagic stroke (such as trauma, tumor, or coordination problems), or impaired sensory integration. Participants were divided into three groups: EMS combined with MT, CIMT alone, and Mirror therapy alone. Treatment sessions were administered four times a week for three months. Outcome measures included the Fugl-Meyer Assessment Scale (FMA) and Motor Assessment Scale (MAS). Results: Analysis revealed significant improvements in upper extremity function across all groups. However, the CIMT group exhibited the most substantial enhancement, with a mean difference of -68.5 (p &lt; 0.05) on the FMA and -24.1 (p &lt; 0.05) on the MAS compared to the other groups. Conclusion: The findings highlight the superior efficacy of CIMT in improving upper extremity function among stroke survivors. Incorporating CIMT into rehabilitation protocols is crucial for optimizing outcomes in this patient population. Further research is warranted to explore the long-term benefits and optimal implementation strategies of CIMT in diverse rehabilitation settings

8585 Using Stimulants to Treat Childhood Obesity

Abstract Disclosure: C. Elatrash: None. S.R. Sisley: None. Background: Hyperphagia, characterized by excessive hunger, can significantly contribute to weight gain in early-onset childhood obesity and lacks an FDA-approved therapy. Stimulants commonly used in the treatment of attention deficit and hyperactivity disorder (ADHD) have a significant side effect of suppressing appetite. However, there is no data on the effectiveness of stimulants to reduce measures of obesity in children with severe obesity and hyperphagia. Methods: We retrospectively analyzed electronic medical records of children &amp;lt; 17 years old with severe, early-onset obesity (defined as a Body Mass Index (BMI) ≥ 120% of the 95th percentile (BMI%95th) prior to age 5 years) who were seen in the Genetic Disorders of Obesity Program (GDOP) at Texas Children’s Hospital (TCH). We included children who had a history of abnormal food behavior consistent with a clinical diagnosis of hyperphagia by having 2 of 9 symptoms of hyperphagia (consuming large portions, consistently feeling hungry, not feeling full with one serving, temper tantrums over food, asking for food frequently, sneaking food, getting up at night to eat, hiding food, constant asking for snacks) and were prescribed lisdexamfetamine treatment for hyperphagia for 6 months. We extracted BMI %95th for up to 12 months prior to treatment and 6 months after treatment. Paired t-tests were utilized to compare data from pre- vs. post-treatment. Results: Our cohort included 22 patients and was 68.2% female, 50% non-Hispanic White, 36.4% Hispanic white, and 13.6% black, with a mean age of 7.73 years±3.82 (range 3-17 years). There was a significant decrease in BMI%95th after treatment with lisdexamfetamine (167.3±38.8 vs. 158.0±40.2; p&amp;lt;0.001). We also observed a significant change in the rate of weight gain after lisdexamfetamine treatment; prior to treatment, patients gained 0.6 BMI%95th points/month compared to a loss of 1.9 points/month after treatment (p=0.002). 16 (72.72%) patients reported tolerable side effects, the rate of side effects was (33)33.33%. 19(57.57%) lasted from 1 week to 1 month and 6(18.18%) lasted more than 1 month. Side effects included adverse behavioral (9)27.27%, sleep disturbance (5)15.15%, and headache (4)12.12%. Conclusion: Children with severe obesity and clinical hyperphagia showed reductions in BMI%95th after six months of lisdexamfetamine treatment. Future research is needed to confirm the clinical efficacy of lisdexamfetamine in this high-risk population. Keywords: Childhood obesity, Stimulants, Hyperphagia, Pharmacologic Treatment Presentation: 6/3/2024