Based on advances in biotechnology and neuroscience, neuromodulation is poised to gain clinical importance as a treatment modality for psychiatric disorders. In addition to old-established electroconvulsive therapy (ECT), clinicians are expected to understand newer forms of neurostimulation, such as deep brain stimulation (DBS), vagus nerve stimulation (VNS), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS). Given the growing interest in non-invasive neuromodulation technologies, clinicians may seek sufficient information about neuromodulation to inform their clinical practice. A growing literature suggests that applications of non-invasive neuromodulation have evidence particularly for indications where treatments are currently insufficient, such as drug-resistant depression. However, positive neuromodulation studies require replication, and the precise interactions among stimulation, antidepressant medication, and psychotherapy are unknown. Further studies of long-term safety and the impact on the developing brain are needed. Non-invasive neuromodulatory devices could enable more individualized treatment. However, do-it-yourself (DIY) stimulation kits require a better understanding of the effects of more frequent patterns of stimulation and raise concerns about clinical supervision, regulation, and reimbursement. Wide spread enthusiasm for therapeutic potential of neuromodulation in clinical practice settings should be mitigated by the fact that there are still research gaps and challenges associated with non-invasive neuromodulatory devices.
Effects of B-HT 920 on the vagally stimulated gastric acid secretion were studied in anesthetized and gastric fistula rats. When the gastric acid secretion was increased by stimulation of the vagus nerve, B-HT 920 was partially attenuated by prazosin, $\alpha_1-$adrenoceptor antagonist and virtually abolished by yohimbine, $\alpha_2-$adrenoceptor antagonist. On the other hand, when the gastric acid secretion was increased by the infusion of bethanechol, a muscarinic parasympathetic stimulant, B-HT 920 had no effect on the bethanechol-induced gastric acid secretion. These results suggest that B-HT 920 inhibits vagally induced gastric acid secretion by activation of presynaptic $\alpha-$adrenoceptors located on the vagally stimulated pathways in the gastric wall and this effect of B-HT 920 is more related to $\alpha_2-$adrenoceptors than $\alpha_1-$adrenoceptors.
Epilepsy has been known to humankind since antiquity. The surgical treatment of epilepsy began in the early days of neurosurgery and has developed greatly. Many surgical procedures have stood the test of time. However, clinicians treating epilepsy patients are now witnessing a huge tide of change. In 2017, the classification system for seizure and epilepsy types was revised nearly 36 years after the previous scheme was released. The actual difference between these systems may not be large, but there have been many conceptual changes, and clinicians must bid farewell to old terminology. Paradigms in drug discovery are changing, and novel anti-seizure drugs have been introduced for clinical use. In particular, drugs that target genetic changes harbor greater therapeutic potential than previous screening-based compounds. The concept of focal epilepsy has been challenged, and now epilepsy is regarded as a network disorder. With this novel concept, stereotactic electroencephalography (SEEG) is becoming increasingly popular for the evaluation of dysfunctioning neuronal networks. Minimally invasive ablative therapies using SEEG electrodes and neuromodulatory therapies such as deep brain stimulation and vagus nerve stimulation are widely applied to remedy dysfunctional epilepsy networks. The use of responsive neurostimulation is currently off-label in children with intractable epilepsy.
Objectives : The aim of this study was to investigate changes of gastric vagal nerve activity and pyloric valve function after execution of combination treatments of both electroacupuncture at Zusanli(ST36) and manual acupuncture at other acupoints in patient with functional dyspepsia. Methods : Bowel sounds of 49 patients (18 male, 31 female) were recorded and their % of bowel sound (%BS) and ratio of dominant frequency (DF) were analyzed. Postprandial %BS was used to indicate the gastric vagal activity after eating. Ratio of postprandial/fasting dominant frequency was used to present the degree of pyloric valve function. According to values of %BS and DF ratio, each patient was classified into normal or abnormal (<6 %BS, hypoactivity: <1 DF ratio, dysfunction) group. For 2 weeks, patients received a treatment consisting of both electroacupuncture stimulation at Zusanli (ST36) and acupuncture at other meridian points. Variation of parameters shifting normal to abnormal or abnormal to normal was observed, and total cure rate was calculated. Results : Total cure rate of %BS was 16%, and that of DF was 37%. Patients who improved to normal value from abnormal or aggravated to abnormal level showed both significant difference in both vagal nerve hypoactivity and pyloric valve dysfunction, respectively. Conclusions : Analysis of bowel sound might be useful to evaluate both gastric vagal nerve activity and pyloric valve function. Combination effects of Zusanli (ST36) electroacupuncture and manual acupuncture of other acupoints showed a bidirectional effect in which their activity and function were in general improved. sometimes from aggravated to abnormal level.
Brain disorders such as epilepsy is a condition that affects an estimated 2.7 million Americans, 50,000,000 worldwide, approximately 200,000 new cases of epilepsy are diagnosed each year. Of the major chronic medical conditions, epilepsy is among the least understood. Scientists are conducting research to determine appropriate treatments, such as the use of drugs, vagus nerve stimulation, brain stimulation, and Peltier chip-based focal cooling. However, brain stimulation and Peltier chip-based stimulation processes cannot effectively stop seizures. This paper presents simulation of a novel heat enchanger network(HEN) technique designed to stop seizures by using a neural cooling probe to stop focal and spontaneous seizures by cooling the brain. The designed probe was composed of a U-shaped tube through which cold fluid flowed in order to reduce the temperature of the brain. The simulation results demonstrated that the neural probe could cool a 7 $mm^2$ area of the brain when the fluid was flowing atb a velocity of 0.55 m/s. It also showed that the neural cooling probe required 23 % less energy to produce cooling when compared to the Peltier chip-based cooling system.
International Journal of Internet, Broadcasting and Communication
/
v.14
no.4
/
pp.222-227
/
2022
The purpose of this study was to investigate changes in heart rate according to recovery methods after circuit weight training exercise. Fourteen men in their twenties were selected as subjects, and three sets of circuit weight training were performed by cycling six sports, and two recovery conditions (dynamic and static) were performed immediately after exercise. Changes in heart rate did not have an interactive effect according to recovery method and time, and both conditions showed significant changes between sets 1 and 2, and between sets 3 and after recovery. In this study, the high heart rate of 2 sets and 3 sets was seen as a result of exercise stimulation, and the low heart rate of 1 set was thought to be due to the decrease in vagus nerve activity rather than the role of catecholamines. On the other hand, the heart rate after 20 minutes of exercise did not show any difference according to the recovery method, which could mean that the recovery process due to the aquatic environment can act more strongly than the process of dynamic recovery and static recovery. It is thought that the characteristics affected the sensory and circulation of the body, and thus the change of the afferent signal and the level of metabolic products generated in the active muscle.
Park, Seung-Soo;Koh, Eun-Jeong;Oh, Young-Min;Lee, Woo-Jong;Eun, Jong-Pil;Choi, Ha-Young
Journal of Korean Neurosurgical Society
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v.41
no.5
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pp.283-290
/
2007
Objective : This study was designed to analyze seizure outcome and to investigate the prognostic factors for predicting seizure outcome according to the preoperative evaluations, surgical procedures, topectomy sites and histopathological findings in patients with extratemporal lobe epilepsy [ETLE]. Methods : This study comprised 63 patients with ETLE who underwent surgery. Preoperative evaluations included semiologic analysis, chronic video-EEG monitoring, and neuroimaging studies. Surgical procedures consisted of topectomy in 51 patients, corpus callosotomy in 9, functional hemispherectomy in 2, and vagus nerve stimulation [VNS] in 1. Histopathological findings were reviewed. Postoperative seizure outcomes were assessed by Engel's classification at the average follow up period of 66.8 months. Chi-square test was used for statistics. Results : Total postoperative seizure outcomes were class I in 51 [80%] patients, class II in 6 [10%], class III in 6 [10%]. Patients with structural abnormalities on neuroimaging study showed class I in 49 [88%] patients [p<0.05]. Patients with focal and regional ictal EEG onset revealed class I in 47 [90%] patients [p<0.05]. Semiologic findings, surgical procedures, topectomy sites and histopathological findings did not show statistical correlation with seizure outcome [p<0.05]. Conclusion : A good seizure outcome was obtained in patients with ETLE. The factors for favorable seizure outcome are related to the presence of structural abnormalities on neuroimaging study, and focal and regional ictal EEG onset.
Park, Hyoung-Jin;Lee, Yun-Lyul;Kwon, Hyeok-Yil;Shin, Won-Im
The Korean Journal of Physiology
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v.20
no.1
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pp.1-7
/
1986
It has been well documented that the peripheral autonomic nervous system plays an important role in exocrine pancreatic secretion. However, the role of the central nervous system in pancreatic function is still obscure even though the central nervous system has been known to control gastrointestinal functions through the autonomic nervous system. Since the reticular formation in the mesencephalone seems to integrate the autonomic function, the present study was undertaken to investigate a possible influence of the reticular formation upon the exocrine pancreatic secretion. Twenty·two albino rats fasted for 24 hours were anesthetized by intraperitoneal injection of urethane in a dose of 1 g/kg, The pancreatic duct was cannulated to collect pancreatic juice and bile juice was diverted to the jejunum. The gastroduodenal junction was ligated to Prevent passage of gastic juice into the duodenum. A pair of electrodes were bilaterally inserted in the reticualr formation of the mesencephalone with aid of a stereotaxic apparatus. When the volume of pancreatic juice secreted for 10 min became constant, the reticular formation was electrically stimulated for 10 min. Parameters of the electical stimulation was 1.3V, 40 Hz and 2 msec. When the pancreatic secretion returned to the level before the electrical stimulation, cervical vagotomy (11 rats) or administration of propranolol (11 rats) in a dose of 0.1 mg/kg through the jugular vein was carried out. Ten minutes after the treatment, the electrical stimulation of the reticular formation was repeated. The brain was fixed by perfusion of 10% formaline solution through the heart, and then placement of the electrode tip was examined histologically. Protein concentration and amylase activity in samples of Pancreatic secretion were measured. The electrical stimulation of the reticular formation significantly increased in volume $({\mu}l/10\;min)$, Protein output $({\mu}g/10\;min)$ and amylase output (U/10 min) in the pancreatic secretion. The stimulatroy effects were not affected by the cervical vagotomy but completely abolished by propranolol. Meantime, it was also observed that both vagotomy and propranolol significantly reduced the pancreatic secretory function. These results indicate that the reticular formation in the mesencephalone may exert a stimulatory effect upon the Pancreatic secretory function not through the vagus nerve but through the sympathetic pathway in anesthetized rats.
Background : The dominant innervation of airway smooth muscle is parasympathetic fibers which are carried in the vagus nerve. Activation of these cholinergic nerves releases acetylcholine which binds to $M_3$ muscarinic receptors on the smooth muscle causing bronchocontraction. Acetylcholine also feeds back onto neuronal $M_2$ muscarinic receptors located on the postganglionic cholinergic nerves. Stimulation of these receptors further inhibits acetylcholine release, so these $M_2$, muscarinic receptors act as autoreceptors. Loss of function of these $M_2$ receptors, as it occurs in animal models of hyperresponsiveness, leads to an increase in vagally mediated hyperresponsiveness. However, there are limited data pertaining to whether there are dysfunctions of these receptors in patients with asthma. The aim of this study is to determine whether there are dysfunction of $M_2$ muscarinic receptors in asthmatic patients and difference of function of these receptors according to severity of asthma. Method : We studied twenty-seven patients with asthma who were registered at Pulmonology Division of Korea University Hospital. They all met asthma criteria of ATS. Of these patients, eleven patients were categorized as having mild asthma, eight patients moderate asthma and eight patients severe asthma according to severity by NAEPP Expert Panel Report 2(1997). All subjects were free of recent upper respiratory tract infection within 2 weeks and showed positive methacholine challenge test ($PC_{20}$<16mg/ml). Methacholine provocation tests were performed twice on separate days allowing for an interval of one week. In the second test, pretreatment with the $M_2$ muscarinic receptor agonist pilocarpine($180{\mu}g$) through inhalation was performed be fore the routine procedures. Results : Eleven subjects with mild asthma and eight subjects with moderate asthma showed significant increase of $PC_{20}$ from 5.30$\pm$5.23mg/ml(mean$\pm$SD) to 20.82$\pm$22.56mg/ml(p=0.004) and from 2.79$\pm$1.51mg/ml to 4.67$\pm$3.53mg/ml(p=0.012) after pilocarpine inhalation, respectively. However, in the eight subjects with severe asthma significant increase of $PC_{20}$ from l.76$\pm$1.50mg/ml to 3.18$\pm$4.03mg/ml(p=0.161) after pilocarpine inhalation was not found. Conclusion : In subjects with mild and moderate asthma, function of $M_2$ muscarinic receptors was normal, but there was a dysfunction of these receptors in subjects with severe asthma. ηlese results suggest that function of $M_2$ muscarinic receptors is different according to severity of asthma.
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