New insights into bioelectronic medicines: A new approach to tackle diabetic peripheral neuropathy pain in clinics

Bioelectronic medicines are a newer way to treat and diagnose the diseases associated with biological systems. All vital organs of the body are innervated, commanding brain to regulate the homeostasis functions. Bioelectronic medicines rely on implications of electrical stimulations or signals associated with the nervous system for real-time treatment. Diabetic peripheral neuropathy (DPN) is a most prevalent micro-vascular complication associated with diabetes mellitus. Complex plexus of nerves were affected in this complication with impaired function. Bioelectronic medicines are future hope for effective treatment of DPN.     

Differential effects of bifrontal tDCS on arousal and sleep duration in insomnia patients and healthy controls

Background

Arousal and sleep represent basic domains of behavior, and alterations are of high clinical importance.

低频电刺激联合膀胱功能训练治疗脊髓损伤诱发的神经源性膀胱的效果评价

目的 评价低频电刺激联合膀胱功能训练治疗脊髓损伤(SCI)诱发的神经源性膀胱(NB)的效果。方法 选取2017年5月～2019年2月我院骨科门诊就诊的SCI诱发NB患者90例,随机分为观察组与单纯组,每组各45例。观察组予以低频电刺激联合膀胱功能训练治疗,单纯组予以单纯的膀胱功能训练,两组均治疗6周。评估两组治疗前后排尿情况及尿动力学指标的变化,并比较其临床疗效。结果 治疗6周后,两组日均单次排尿量和日单次最大排尿量较治疗前明显增加,日均排尿次数较治疗前明显下降(P0.05或P0.01),且观察组变化幅度较单纯组更显著(P0.05);两组膀胱内压力和Qmax较治疗前明显上升,RU较治疗前明显下降(P0.05或P0.01),且观察组变化幅度较单纯组更显著(P0.05);同时观察组临床总有效率(95.56%)明显高于单纯组(82.22%)(χ2=4.053,P0.05)。结论 低频电刺激联合膀胱功能训练用于治疗SCI诱发NB患者的效果确切,能更明显改善患者的排尿情况及尿动力学状态。     

Effect of multichannel transcranial direct current stimulation to reduce hypertonia in individuals with prolonged disorders of consciousness: A randomized controlled pilot study

BackgroundSpasticity management in severely brain-injured patients with disorders of consciousness (DOC) is a major challenge because it leads to complications and severe pain that can seriously affect quality of life.ObjectivesWe aimed to determine the feasibility of a single session of transcranial direct current stimulations (tDCS) to reduce spasticity in chronic patients with DOC.MethodsWe enrolled 14 patients in this double-blind, sham-controlled randomized crossover pilot study. Two cathodes were placed over the left and right primary motor cortex and 2 anodes over the left and right prefrontal cortex. Hypertonia of the upper limbs and level of consciousness were assessed by the Modified Ashworth Scale (MAS) and the Coma Recovery Scale-Revised (CRS-R). Resting state electroencephalography was also performed.ResultsAt the group level, spasticity was reduced in only finger flexors. Four responders (29%) showed reduced hypertonicity in at least 2 joints after active but not sham stimulation. We found no behavioural changes by the CRS-R total score. At the group level, connectivity values in beta2 were higher with active versus sham stimulation. Relative power in the theta band and connectivity in the beta band were higher for responders than non-responders after the active stimulation.ConclusionThis pilot study highlights the potential benefit of using tDCS for reducing upper-limb hypertonia in patients with chronic DOC. Large-sample clinical trials are needed to optimize and validate the technique.     

Electrical pulse stimulation of skeletal myoblasts cell cultures with simulated action potentials

Electrical pulse stimulation has an important effect on skeletal muscle development and maturation. However, the methodology for controlling these stimulation parameters to develop in vitro functional skeletal muscle tissues remains to be established. In this work, we have studied the effect of simulated action potentials on the growth and differentiation of skeletal myoblast cell cultures. A circuit simulating action potentials of 0.15 and 0.3 V/mm, at a frequency of 1 Hz and with a 4‐ms pulse width, is proposed. Results show an important improvement of the growth rate and differentiation of myoblasts at a voltage of 0.15 V/mm. Parameters such as electrodes geometry or type of signals must be considered in the development of in vitro skeletal muscle.     

Stereotactic Radiosurgery Versus Whole Brain Radiation Therapy: A Propensity Score Analysis and Predictors of Care for Patients With Brain Metastases From Breast Cancer

Background

Metastases to the brain occur in 10%-16% of patients with breast cancer, with incidence reportedly increasing. Historically, brain metastases (BM) have been treated with whole-brain radiation therapy (WBRT), but stereotactic radiosurgery (SRS) is an increasingly favored treatment option. In this study we used a population-level database to compare patterns of care and survival between WBRT and SRS for BM from breast cancer.