Stimulation Treatment Research Articles

The positive effect of pulse electromagnetic field therapy on pain and disability in chronic low back pain: a comparative study

BackgroundLow back pain that lasts longer than three months is called chronic low back pain. Chronic low back pain is among the most common problems in the world, causing severe disability and loss of employment in patients.ObjectiveTo investigate the effect of pulse electromagnetic field therapy (PEMFT) added to routine physical therapy on pain and functional status in patients with chronic low back pain.MethodsThis retrospective comparative study included 69 patients with chronic low back pain. The patients were divided into two groups: those who received lumbar transcutaneous electrical nerve stimulation, infrared, and ultrasound treatments, and those who additionally received PEMFT. The files of patients with chronic low back pain were reviewed, and those who had been evaluated using the Quebec Back Pain Disability Scale (QBPDS) in terms of functional capacity and effects of low back pain and the Visual Analogue Scale (VAS) for pain both before and after treatment were included in the study.ResultsNo significant difference was detected between the two groups’ pretreatment VAS and QBPDS scores (p > 0.05). The second-and-third measurement scores of both groups were significantly lower than their first-measurement VAS and QBPDS scores (p ˂ 0.001), but there was no significant difference between their second- and third-measurement scores (p > 0.05). According to the inter-group comparison of the VAS and QBPDS scores, the second and third-measurement scores of the PEMFT group were significantly lower than those of the control group (p ˂ 0.001).ConclusionsPEMFT seems to be able to alleviate pain intensity and ameliorate disability in patients with chronic low back pain. PEMFT can be considered an effective and safe option that can be added to routine physical therapy modalities for relieving chronic low back pain frequently encountered in clinical practice. Further studies validating the effectiveness of PEMFT could strengthen its position in the management of chronic low back pain.

Densely sampled stimulus-response map of human cortex with single pulse TMS-EEG and its relation to whole brain neuroimaging measures.

Large-scale networks underpin brain functions. How such networks respond to focal stimulation can help decipher complex brain processes and optimize brain stimulation treatments. To map such stimulation-response patterns across the brain non-invasively, we recorded concurrent EEG responses from single-pulse transcranial magnetic stimulation (i.e., TMS-EEG) from over 100 cortical regions with two orthogonal coil orientations from one densely-sampled individual. We also acquired Human Connectome Project (HCP)-styled diffusion imaging scans (six), resting-state functional Magnetic Resonance Imaging (fMRI) scans (120 mins), resting-state EEG scans (108 mins), and structural MR scans (T1- and T2-weighted). Using the TMS-EEG data, we applied network science-based community detection to reveal insights about the brain's causal-functional organization from both a stimulation and recording perspective. We also computed structural and functional maps and the electric field of each TMS stimulation condition. Altogether, we hope the release of this densely sampled (n=1) dataset will be a uniquely valuable resource for both basic and clinical neuroscience research.

Neuroimaging-based study of scalp acupuncture targets for common psychiatric diseases (Part 2)

In this study, based on the neuroimaging literature Meta analysis retrieved from Neurosynth platform, the scalp stimulation targets for common psychiatric diseases are developed, which provided the stimulation target protocols of scalp acupuncture for attention deficit hyperactivity disorder, autism spectrum disorder, obsessive-compulsive disorder and schizophrenia. The paper introduces the functions of the brain areas that are involved in each target and closely related to the diseases, and lists the therapeutic methods of common acupuncture/scalp acupuncture and common neuromodulation methods for each disease so as to provide the references for clinical practice. Based on the study results above, the paper further summarizes the overlapped stimulation targets undergoing the intervention with scalp acupuncture for common psychiatric diseases, and the potential relationship between these stimulation targets and treatments with acupuncture and moxibustion.

A review of prospective studies regarding percutaneous peripheral nerve stimulation treatment in the management of chronic pain.

Conventionally, peripheral nerve stimulation (PNS) for treatment of chronic pain has involved a two-stage process: a short-term (e.g., 7days) trial and, if significant pain relief is achieved, a permanent PNS system is implanted. A percutaneous PNS treatment is now available where a coiled lead may be implanted for up to 60days with the goal of producing sustained relief. In the present review, published prospective trials using percutaneous PNS treatment were identified and synthesized. The collected evidence indicates that percutaneous PNS treatment for up to 60days provides durable clinically significant improvements in pain and pain interference. Similar efficacy across diverse targets and etiologies supports the broad applicability for use within the chronic pain population using this nonopioid technology.

Is Stimulant Treatment in Children and Adolescents with Mood Dysregulation Associated with Adverse Outcomes?

The aim of this paper is to examine effects of stimulant treatment in children and adolescents with high levels of emotional dysregulation in a psychiatric outpatient clinic. Subjects were referred children and adolescents 6-17 years of age who presented to a child psychiatric outpatient clinic between September 2016-November 2021 and received a prescription for a stimulant medication. Children were stratified into those with low and high levels of emotional dysregulation as defined by an aggregate T-score of <180 or ≥210 on the combined Attention Problems, Aggressive Behavior, and Anxious/Depressed subscales of the Child Behavior Checklist (CBCL; CBCL-AAA). We analyzed patient prescription, diagnosis, and hospital visit data extracted from the electronic medical record from any time prior to referral through three months after referral. Patients with higher CBCL-AAA scores at clinic intake had a significantly different medication and diagnosis profile and were more likely to have a higher dosage of stimulants than patients with lower scores. These patients also were more likely to receive an additional medication class during follow-up, which was driven by second-generation antipsychotics (SGAs). Emergency room visits and inpatient psychiatric admissions were rare but present only in the group with higher CBCL-AA scores. These results suggest that stimulant treatment affects youth with high versus low levels of emotional dysregulation adversely with a need for higher stimulant doses and treatment augmentation with SGAs. The CBCL may be a useful tool for identifying poor outcomes with stimulant treatment.

Differential symptom cluster responses and predictors to repetitive transcranial magnetic stimulation treatment in Parkinson's disease: A retrospective study

BackgroundRepetitive transcranial magnetic stimulation (rTMS) is an effective noninvasive neuromodulation technique for Parkinson's disease (PD). However, the efficacy of rTMS varies widely between individuals. This study aimed to investigate the factors related to the response to rTMS in PD patients. MethodsWe retrospectively analyzed the response of 70 idiopathic PD patients who underwent rTMS for 14 consecutive days targeting the supplementary motor area (SMA) in either an open-label trail (n = 31) or a randomized, double-blind, placebo-controlled trial (RCT) (n = 39). The motor symptoms of PD patients were assessed by the United Parkinson's Disease Rating Scale Part III (UPDRSIII). Based on previous studies, the UPDRSIII were divided into six symptom clusters: axial dysfunction, resting tremor, rigidity, bradykinesia affecting right and left extremities, and postural tremor. Subsequently, the efficacy of rTMS to different motor symptom clusters and clinical predictors were analyzed in these two trails. ResultsAfter 14 days of treatment, only the total UPDRSIII scores and rigidity scores improved in both the open-label trial and the RCT. The results of multiple linear regression analysis indicated that baseline rigidity scores (β = 0.37, p = 0.047) and RMT (β = 0.30, P = 0.02) positively predicted the improvement of UPDRSIII. The baseline rigidity score (β = 0.55, P < 0.0001) was identified as an independent factor to predict the improvement of rigidity. ConclusionThis study demonstrated significant improvements in total UPDRSIII scores and rigidity after 14-day treatment, with baseline rigidity scores and RMT identified as predictors of treatment response, underscoring the need for individualized therapy.

Practice Pearls for Stimulant Treatment of Attention-Deficit/Hyperactivity Disorder in Youth.

Over half of youth with attention-deficit/hyperactivity disorder (ADHD) have co-occurring psychiatric or medical conditions that present treatment challenges. Stimulants are the most effective pharmacologic treatment of ADHD for preschoolers to adults but questions about safety with co-occurring conditions frequently arise. In addition, stigma surrounding diagnosis and treatment can negatively impact care. This manuscript presents evidence-based practice pearls to guide treatment decisions for youth with ADHD and common coexisting psychiatric and medical conditions. Recommendations address specific stimulant adverse effects (i.e., anxiety, cardiac, growth, mania, psychosis) along with management strategies. Pearls were developed for the most common clinical questions, controversial topics, or therapeutic issues that may not be widely known. The goals of this manuscript are to: 1) provide a detailed resource for interprofessional teams regarding stimulant use in youth with ADHD, 2) improve therapeutic outcomes for youth with ADHD and co-occurring psychiatric and/or medical conditions through evidence-based recommendations, and 3) decrease stigma associated with stimulant use through education.

Clinical procedures for in vitro maturation treatment

To demonstrate clinical techniques for invitro maturation (IVM) treatment, including stimulation recommendations, small follicle pick-up procedures, and compact cumulus-oocyte complex (COC) search practice. This video utilizes live-action footage from surgery and embryology practice for a representative IVM treatment cycle, with step-by-step instructions and recommendations for practice procedures. Invitro fertilization (IVF) clinic. Patients undergoing IVM treatment. The patient(s) included in this video gave consent for publication of the video and posting of the video online, including on social media, the journal website, scientific literature websites, and other applicable sites. Identification of treatment cohorts, IVM definitions, and recommendations for stimulation treatments. A visual demonstration of COC extraction techniques from small antral follicles includes tubing, needle types, considerations when using double lumen or sheath needles, needle pressure, ultrasound, needle flushing, and aspiration technique. Visual demonstration of oocyte search and IVM preparation, including filtering follicular aspirate, prevention of COC cooling, identification of compact COCs, and general parameters of different IVM approaches. Clinical techniques for small follicle ovum pick up and compact COC identification for IVM treatment. Successful IVM treatment of patients can be achieved using minimal ovarian stimulation, effective small follicle retrieval, and efficient compact COC identification with flexibility in approach depending on clinical constraints and preference. Invitro maturation treatment is an efficacious and safe treatment for high ovarian reserve and hyper-responding patients undergoing IVF treatment, in which the retrieval of multiple immature COCs and their exvivo maturation can be achieved with little to no invivo stimulation. Practice procedures vary between treatment centers and IVM techniques. This video provides practice recommendations paired with a visual demonstration of techniques to assist in standardizing the approach and expanding the practice to more centers.

Flowback Additive for Acidizing Fluid to Stimulate Carbonate Gas Reservoirs

Summary Acidizing of oil- and gas-bearing carbonate reservoirs is generally undertaken by using strong mineral acids such as hydrochloric acid (HCl) to enhance permeability. One of the major challenges associated with HCl injection is tuning the reactivity profile to favor the transport of live acid deep into the reservoir while achieving a minimum rock face dissolution. The mineral acid is therefore emulsified in a hydrocarbon phase (e.g., diesel) to retard its reactivity with the rock matrix. The use of emulsified acid is hindered by several limitations such as low emulsion stability at high temperatures, pumping limitations due to high viscosity, the potential of formation damage, and cumbersome mixing procedures at the field scale. In addition, the brines formed as a result of this reaction can be difficult to produce due to higher density and capillary pressures, unfavorable wettability, and low formation pressure. Here, we report on the development of dual-purpose additives that were specifically designed to enhance the recovery of high-density brines and retard the acid/rock reactivity upon addition to the stimulation treatment. Accordingly, seven new additives with fluid flowback properties were developed for use in a single-phase acidizing fluid consisting of HCl (15 wt% and 28 wt%) with the required additives, such as corrosion inhibitor and intensifier, and H2S scavenger. The flowback enhancers (FBEs) were formulated from a blend of water, ester or terpene solvents, alcohols, and surfactants to form optically clear nano- and microemulsions. Surfactant selection was driven by the need to exhibit demulsification properties with condensate, high chemical and thermal stability, compatibility in strongly acidic media, and high-density brines under harsh reservoir conditions. To assess the FBE performance in acidizing formulations (i.e., to serve as both an FBE and retarder), screening studies consisting of static rock dissolution tests and surface tension measurements were performed to downselect FBEs suitable for this application. This was coupled with brine displacement tests in addition to compatibility and stability studies. FBEs that demonstrated superior performance were then selected for further evaluation under reservoir conditions [i.e., core flow matrix acidizing to measure regained permeability and computed tomography (CT) scan for analyzing the wormhole propagation]. The droplet size of the as-prepared nano- and microemulsions was found to be between 10 nm and 850 nm. The FBEs formulated in this study were found to prevent emulsion formation in the presence of condensate and demonstrated remarkable chemical and thermal stability in concentrated acid at temperatures up to 300°F for a duration of up to 24 hours, as confirmed by the consistent low surface tension values (21–29 mN/m). With regard to fluid displacement, column tests performed under ambient conditions revealed quick brine displacement with recovery exceeding 75 vol% in comparison with 16 vol% in the absence of the FBE. Interestingly, the addition of a select FBE from this study to 28 wt% HCl was found to retard the reaction of carbonate dissolution at room temperature. This led us to assess the performance under reservoir conditions utilizing core flow testing. Accordingly, the addition of FBE-F to 28 wt% HCl led to an improvement in permeability by up to 267% as compared with 15% without FBE added. These results are further supported by the CT scan images of the acidized cores, which revealed the formation of a deeper wormhole in the presence of a select FBE.

The Role of Pelvic Floor Muscle Exercise in Erectile Dysfunction

PURPOSE: This study aimed to determine the role or applicability of pelvic floor muscle exercise for erectile dysfunction.METHODS: This narrative review was conducted by searching terms such as “erectile dysfunction”, “erection dysfunction”, “sexual dysfunction”, and “pelvic floor muscle training”, “pelvic floor muscle exercise”, “pelvic floor exercise”, “randomized controlled trials”, “randomized clinical trials” in PubMed, Google Scholar, Scopus, and Web of Science.RESULTS: Seven articles met the inclusion criteria. Six studies applied pelvic floor muscle exercise, electrical stimulation, and biofeedback treatment to patients with erectile dysfunction after radical prostatectomy. Only three studies showed that treatment in the intervention group had a significant effect on erectile function. Considering these results, the study subjects who applied the three treatment methods presented above were mainly patients with erectile dysfunction caused by prostate cancer surgery.CONCLUSIONS: Seven randomized controlled trials showed no significant effect of pelvic floor muscle exercise on erectile dysfunction. However, they are thought to have applicability as a method for treating erectile dysfunction. In studies of erectile dysfunction caused by radical prostatectomy, homogeneity in the age, duration of erectile dysfunction, and nerve-sparing surgery should be ensured between the intervention and control groups. First, future clinical research is required to determine whether existing methods and concurrent treatment with drugs, such as sildenafil (Viagra) and tadalafil (Cialis) can shorten the recovery period of erectile function. Second, clinical research is needed to analyze the differences in changes in erectile function between those performing aerobic exercise and pelvic floor muscle exercise combined and those performing only pelvic floor muscle exercise.

Deep brain stimulation of symptom-specific networks in Parkinson’s disease

Deep Brain Stimulation can improve tremor, bradykinesia, rigidity, and axial symptoms in patients with Parkinson’s disease. Potentially, improving each symptom may require stimulation of different white matter tracts. Here, we study a large cohort of patients (N = 237 from five centers) to identify tracts associated with improvements in each of the four symptom domains. Tremor improvements were associated with stimulation of tracts connected to primary motor cortex and cerebellum. In contrast, axial symptoms are associated with stimulation of tracts connected to the supplementary motor cortex and brainstem. Bradykinesia and rigidity improvements are associated with the stimulation of tracts connected to the supplementary motor and premotor cortices, respectively. We introduce an algorithm that uses these symptom-response tracts to suggest optimal stimulation parameters for DBS based on individual patient’s symptom profiles. Application of the algorithm illustrates that our symptom-tract library may bear potential in personalizing stimulation treatment based on the symptoms that are most burdensome in an individual patient.

Effects of different mylohyoid muscle stimulations on swallowing cortex excitability in healthy subjects

BackgroundDysphagia has been recognized by the World Health Organization as a medical disability. Improving mylohyoid muscle function plays an important role in pharyngeal dysphagia. The aim of this study was to evaluate the treatment of transcranial magnetic stimulation (TMS), peripheral magnetic stimulation (PMS), and electrical stimulation (ES) for dysphagia. MethodsForty healthy subjects were randomly divided into four groups: TMS+PMS, TMS, PMS, and ES. TMS stimulated the cortical representative area of the mylohyoid muscle and the PMS was directly stimulating the mylohyoid muscle, both of them at a frequency of 10 Hz for a total of 1,800 pulses. The intensity of ES was based on the subject’s tolerance level, usually 2–5 mA. Functional near infrared spectroscopy (fNIRS) and motor evoked potential (MEP) of the mylohyoid muscle were used to evaluate the immediate effects of stimulation on swallowing cortex excitability of healthy subjects before and after intervention. ResultsThe fNIRS results revealed notable activation across multiple channels in the four groups of healthy subjects both pre- and post- the intervention. Among these channels, the activation levels were most pronounced in the TMS+PMS group, followed by the TMS, PMS, and ES groups, respectively. Regarding the MEP results, post-intervention observations indicated a reduction in bilateral latency and an increase in bilateral amplitude in the TMS+PMS group. Additionally, the left amplitude exhibited an increase in the TMS group. ConclusionsIn fNIRS, all four stimulation methods significantly activated the swallowing cortex of healthy subjects, and the activation of TMS+PMS was the most obvious, followed by TMS, PMS, and ES.

Activation of Pedunculopontine Tegmental Nucleus Alleviates the Pain Induced by the Lesion of Midbrain Dopaminergic Neurons.

The loss of midbrain dopaminergic (DA) neurons is the fundamental pathological feature of Parkinson's disease (PD). PD causes chronic pain in two-thirds of patients. Recent studies showed that the activation of the pedunculopontine tegmental nucleus (PPTg) can effectively relieve inflammatory pain and neuropathic pain. The PPTg is located in the pontomesencephalic tegmentum, a target of deep brain stimulation (DBS) treatment in PD, and is involved in motor control and sensory integration. To test whether the lesion of midbrain DA neurons induced pain hypersensitivity, and whether the chemogenetic activation of the PPTg could modulate the pain, the AAV-hM3Dq receptor was transfected and expressed into the PPTg neurons of 6-hydroxydopamine-lesioned mice. In this study, von Frey, open field, and adhesive tape removal tests were used to assess animals' pain sensitivity, locomotor activity, and sensorimotor function and somatosensory perception, respectively. Here, we found that the lesion of midbrain DA neurons induced a minor deficit in voluntary movement but did not affect sensorimotor function and somatosensory perception in the tape removal test. The results showed that lesion led to pain hypersensitivity, which could be alleviated both by levodopa and by the chemogenetic activation of the PPTg. Activating the PPTg may be a potential therapeutic strategy to relieve pain phenotypes in PD.

METHODOLOGY AND FEATURES OF RESEARCH OF FILTRATION PROPERTIES OF COMPACTED DEEP-SEATED ROCKS

As a result of the depletion of conventional hydrocarbon reserves, there is a need to explore deposits at great depths and under difficult geological conditions. This requires the improvement of technologies for studying rocks and fluids using computer modeling systems and laboratory equipment. Laboratory modeling of the processes occurring in rocks during drilling, development, stimulation or various chemical treatments plays a significant role in modern hydrocarbon production, as it reduces the number of errors at the design stage of field development or methods of impacting productive formations. There are a number of well-known manufacturers of laboratory equipment that model filtration processes in rocks, but any system has both advantages and disadvantages. To implement the tasks of studying filtration processes in rocks, technologies for the development of compacted and conventional reservoirs, stimulation methods and physical and chemical effects in hydrocarbon production, filtration equipment has been developed that allows for standard and special studies of rock core material. The first low-pressure unit allows for fast and accurate measurements of porosity and permeability at pressures up to 10 MPa and temperatures up to 120℃. In addition to filtration processes, the equipment allows for evaluation studies of the impact of various chemical solutions, drilling and other process fluids on natural and artificial cores in scientific and industrial research. For the study of rocks and fluids in reservoir conditions, a filtration system has been developed that allows for all of the above studies at pressures up to 100 MPa and temperatures up to 200℃. The peculiarity of the developed equipment is high accuracy of measurements, automation of monitoring processes, corrosion-resistant design of the main components and assemblies, which allows conducting research in any aggressive environment. Laboratory studies allow avoiding mistakes in the design of new areas development, reducing drilling accidents and selecting effective technologies for rock impact.

EFFECTIVENESS OF COGNITIVE STIMULATION THERAPY(CST) AMONG PEOPLE WITH DEMENTIA - A NARRATIVE REVIEW

OBJECTIVE: This study explores the effectiveness of cognitive stimulation therapy to improve cognition in people with dementia. SELECTION METHOD: PubMed, Google Scholar, Science Direct, Cochrane from these databases, articles were searched using keywords. SELECTION CRITERIA: The articles were collected based on the inclusion criteria focusing on the cognition in people with dementia. RESULTS: The preliminary results suggested that the tasks like measuring attention, memory, speed processing, executive functions, and speed processing following the cognitive stimulation treatment (CST). Evidence shows that CST promisingly improves people’s cognitive functions as measured by the (MMSE) mini-mental state examination. This test investigates memory, orientation, language, and visuospatial abilities. CST has led to significant improvements in quality of life, along with care givers. Analyses suggests CST is equally effective as many dementia drugs. CONCLUSION: Cognitive stimulation therapy improves cognition in people with dementia and benefits the quality of life. Evidence from several studies indicates that cognitive stimulation therapy along with multiple component interventions improves not only cognition but also the language, behavior, and quality of life of people with dementia. Results from interviews of CST sessions found key themes, including positivity being in the groups, due to a supportive and good environment, improvements in confidence, mood, and concentration. KEY WORDS: Non-Pharmacological intervention, Cognitive stimulation therapy (CST), People with Dementia (PwD), Cognition, Older adults, assessment scales, Quality of life (QoL).

The Clinical Management of Electrical Stimulation Therapies in the Rehabilitation of Individuals with Spinal Cord Injuries.

Background: People with spinal cord injuries (SCIs) often have trouble remaining active because of paralysis. In the past, exercise recommendations focused on the non-paralyzed muscles in the arms, which provides limited benefits. However, recent studies show that electrical stimulation can help engage the paralyzed extremities, expanding the available muscle mass for exercise. Methods: The authors provide an evidence-based approach using expertise from diverse fields, supplemented by evidence from key studies toward the management of electrical stimulation therapies in individuals with SCIs. Literature searches were performed separately using the PubMed, Medline, and Google Scholar search engines. The keywords used for the searches included functional electrical stimulation cycling, hybrid cycling, neuromuscular electrical stimulation exercise, spinal cord injury, cardiovascular health, metabolic health, muscle strength, muscle mass, bone mass, upper limb treatment, diagnostic and prognostic use of functional electrical stimulation, tetraplegic hands, and hand deformities after SCI. The authors recently presented this information in a workshop at a major rehabilitation conference. Additional information beyond what was presented at the workshop was added for the writing of this paper. Results: Functional electrical stimulation (FES) cycling can improve aerobic fitness and reduce the risk of cardiovascular and metabolic diseases. The evidence indicates that while both FES leg cycling and neuromuscular electrical stimulation (NMES) resistance training can increase muscle strength and mass, NMES resistance training has been shown to be more effective for producing muscle hypertrophy in individual muscle groups. The response to the electrical stimulation of muscles can also help in the diagnosis and prognosis of hand dysfunction after tetraplegia. Conclusions: Electrical stimulation activities are safe and effective methods for exercise and testing for motor neuron lesions in individuals with SCIs and other paralytic or paretic conditions. They should be considered part of a comprehensive rehabilitation program in diagnosing, prognosing, and treating individuals with SCIs to improve function, physical activity, and overall health.

Therapeutic effect of manual massage on early postpartum rectus abdominis separation and postpartum depression.

Rectus abdominis separation (DRA) affects pelvic stability and body image. No studies have explored the effects of manual massage on early postpartum DRA and postpartum depression. To analyze the curative effect of massage on early postpartum DRA and its impact on postpartum depression and thus its ability promote the overall psychosomatic rehabilitation of postpartum women. Data were retrospectively collected on 70 primiparous women with postpartum DRA who underwent rehabilitation at the Postpartum Rehabilitation Center of Huzhou Maternal and Child Health Hospital from October 2022 to September 2023. The patients were divided into the Group S (35 cases, biomimetic electrical stimulation treatment) and Group L (35 cases, biomimetic electrical stimulation combined with manual massage treatment). Baseline data, the edinburgh postpartum depression scale (EPDS) score, and the visual analog scale (VAS) scores for rectus abdominis distance, waist circumference, and lower back pain before and after treatment were compared. No significant differences were found in the baseline data, rectus abdominis distance, waist circumference, and VAS and EPDS scores between the two groups before treatment (P > 0.05). After treatment, the distance between rectus abdominis and waist circumference in Group L were significantly smaller than those in Group S (P < 0.05). Furthermore, lower back pain (VAS score) and the EPDS score in Group L were significantly lower than those in Group S (P < 0.05). Manual massage can significantly reduce early postpartum DRA, waist circumference, and back pain and improve the patient's mental state and postpartum depression.

Nano-Pulse Stimulation Treatment Inhibits Pan02 Murine Pancreatic Tumor Growth and Induces a Long-Term Adaptive Immune Response with Abscopal Effects When Combined with Immune-Enhancing Agents.

Pancreatic cancer is associated with a poor prognosis and immunotherapy alone has not demonstrated sufficient efficacy in the treatment of nonresectable tumors. Nano-Pulse Stimulation™ therapy (NPS™) applies nanosecond electric pulses that lead to regulated cell death, exposing tumor antigen to the immune system. To establish a primary Pan02 tumor, mice were intradermally injected with Pan02 cells into the right flank. Secondary, rechallenge tumors and distal, secondary tumors (abscopal response) were established by injecting Pan02 cells into the opposite left flank. After 5 days of tumor growth, one of the tumors was treated with NPS, followed by injection with an immune-enhancing agent to stimulate an immune response. Growth of the treated primary tumor and untreated rechallenge tumors (injected 60-days post-treatment) or distal secondary tumors (injected simultaneously with the primary) was monitored. NPS in combination with the adjuvant and TLR agonist, resiquimod (RES), was the optimal treatment regimen for both eliminating a primary Pan02 tumor as well as inhibiting growth of a Pan02 cell rechallenge tumor. This inhibition of the rechallenge tumor injected 2 months after eliminating the primary tumor suggests a long-term immune response had been stimulated. Additional support for this came from the observations that depleting CD8+ T-cells reduced inhibition of rechallenge tumor growth by 35% and rechallenge tumors had 3-fold more CD8+ T-cells than tumors injected after surgical resection of the primary tumor. When the NPS-treated tumor was immediately injected with the anti-OX40 antibody to agonize the function of the costimulatory T cell receptor, OX40, up to 80% of untreated abscopal tumors were eliminated. NPS plus RES was the most effective at both eliminating a primary tumor and inhibiting a rechallenge tumor. NPS treatment followed by injection of aOX40 was the most effective at inhibiting the growth of an untreated abscopal tumor.

Treating refractory obsessive compulsive disorder with cathodal transcranial direct current stimulation over the supplementary motor area: a large multisite randomized sham-controlled double-blind study.

The present study evaluated the therapeutic efficacy and tolerability of 10 transcranial direct current stimulation (tDCS) sessions in treatment-resistance obsessive-compulsive disorder (OCD) patients using a multisite double-blind sham-controlled design. Eighty treatment-resistance outpatients suffering from obsessive-compulsive disorder were randomized to receive either active or sham transcranial direct current stimulation. The cathode was positioned over the supplementary motor area and the anode over the right supraorbital area. Patients were evaluated at baseline, end of treatment (day 14), one-month follow-up (day 45), and three-month follow-up (day 105) on the Yale-Brown Obsessive Compulsive Scale. Although a significant interaction between time and treatment was observed, the primary endpoint-measuring the change in Yale-Brown obsessive compulsive scale scores after two weeks-was not achieved. Conversely, the secondary endpoint, which concerned the change in Yale-Brown obsessive compulsive scale scores after three months, was successfully met. It is important to note, however, that there were no significant differences in the percentage of responders and remitters at any of the post-treatment assessments. This suggests that the treatment may not have had a clinically relevant impact. Patients well received the transcranial direct current stimulation treatment, indicating its good tolerability. This is the largest controlled trial using transcranial direct current stimulation in treatment-resistance obsessive-compulsive disorder patients. Our results indicate the importance of studying the placebo effect in transcranial direct current stimulation and the necessity to consider a long follow-up time to best evaluate the effects of the intervention. ClinicalTrials.gov, identifier NCT03304600.

Transcranial electrical stimulation (TES) in patients with atopic dermatitis

BACKGROUND: Atopic dermatitis is the most common diseases in dermatology, among the main pathogenetic mechanisms of development of which a complex interaction of a genetically determined defect in the barrier function of the skin, an overactive state of the immune system is considered, and a neurogenic theory of disease development is not excluded, which is based on the relationship of anxiety-stress reactions and neuropsychiatric stresses with the occurrence of pathological changes on the skin. Modern atopic dermatitis therapy is characterized by the appointment of a large number of medications according to clinical recommendations, and the associated increase in allergic and toxic-allergic reactions dictates the need to search for new non-drug treatments for this disease. In order to prevent the pathological effects of stress, as well as to increase resistance to its damaging effects, activation of opioidergic mechanisms may be useful. AIM: To evaluate the effectiveness and acceptability of the transcranial electrical stimulation technique in patients with atopic dermatitis. MATERIALS AND METHODS: A controlled study was conducted among 60 patients with moderate atopic dermatitis, 33 women (55.0%) and 27 men (45.0%) aged 19 to 72 years. Transcranial electrical stimulation was carried out by a pulsed bipolar electrical stimulator with an acoustic effect "TRANSAIR-07", stimulation was carried out by an electric current with a frequency of 77.5 Hz and a duration of 3.5 ms. Patients underwent 10 procedures, 1 time a day, lasting 30 minutes, with a current of 1−3 mA. SCORAD, EASI, IGA, DLQI, HADS, and BDI scales were used to assess the dynamics of clinical manifestations. The assessment was carried out on the first and last day of treatment. RESULTS: During statistical data processing, when comparing the scales in the first and last days of the procedures, depending on the patient groups: the 1st group was the main one, received transcranial electrical stimulation treatment in combination with therapy, according to clinical recommendations, the 2nd group was the control group, received treatment according to clinical recommendations, without the use of transcranial electrical stimulation, significant improvement of itching indicators, clinical manifestations and improvement of quality of life after 4 weeks of therapy in both groups. A statistically more significant dynamics of the indicators of the main clinical scales in favor of combination therapy was established: according to the SCORAD scale ― in the main group from 47.50±2.25 to 21.00±1.00, in the control group from 47.00±2.00 to 39.00±1.75; DLQI ― in the main group from 8.00±2.00 to 2.00±0.75, in the control group ― from 8.50±1.50 to 5.00±1.00. CONCLUSION: The paper presents the positive results of our own research and presents data confirming the clinical effectiveness of transcranial electrostimulation in patients with atopic dermatitis compared with the traditional drug treatment of this disease, which allows us to recommend the treatment regimen we have proposed for widespread implementation in the practice of a dermatovenerologist.