Neurological disorders with symptoms such as chronic pain,depression,and insomnia are widespread.Very weak electric fields applied through the skull can enhance or diminish neural activity and modulate brain waves in ...Neurological disorders with symptoms such as chronic pain,depression,and insomnia are widespread.Very weak electric fields applied through the skull can enhance or diminish neural activity and modulate brain waves in order to treat many of these common medical problems.This approach is to be contrasted with well-established pharmacological methods or more recent invasive electrical Deep Brain Stimulation(DBS)techniques that require surgery to insert electrodes deep into the brain.We claim that Non-Invasive Brain Stimulation(NIBS)will provide new treatment methods with much greater simplicity,lower cost,improved safety and in some cases,possibly greater effectiveness.This emerging use of NIBS is a branch of a new multidisciplinary field that we coined Neuro-systems Engineering[1].This field involves neuroscientists,psychologists,and electrical engineers.This emerging field relies on existing standards for the safe implementation of these novel treatment modalities[2].Methods of stimulating the brain are based on emerging electro-technologies such as transcranial Direct Current/Alternating Current(DC/AC)electric fields and pulsed magnetic fields.Application of functional and time-dependent brain imaging methods can be used to locate relevant brain regions and determine the most appropriate stimulation method.Application of tailored and individualized control can be combined with other therapy methods to effectively treat neurological disorders while minimizing or even eliminating the use of pharmaceuticals.In this paper,we are presenting our embodiment for a closed loop,feedback controlled,non-invasive application of electrical stimulation of the brain to enhance individual/group performance or to treat neurological disorders.展开更多
Gait disorders drastically affect the quality of life of stroke survivors,making post-stroke rehabilitation an important research focus.Noninvasive brain stimulation has potential in facilitating neuroplasticity and i...Gait disorders drastically affect the quality of life of stroke survivors,making post-stroke rehabilitation an important research focus.Noninvasive brain stimulation has potential in facilitating neuroplasticity and improving post-stroke gait impairment.However,a large inter-individual variability in the response to noninvasive brain stimulation interventions has been increasingly recognized.We first review the neurophysiology of human gait and post-stroke neuroplasticity for gait recovery,and then discuss how noninvasive brain stimulation techniques could be utilized to enhance gait recovery.While post-stroke neuroplasticity for gait recovery is characterized by use-dependent plasticity,it evolves over time,is idiosyncratic,and may develop maladaptive elements.Furthermore,noninvasive brain stimulation has limited reach capability and is facilitative-only in nature.Therefore,we recommend that noninvasive brain stimulation be used adjunctively with rehabilitation training and other concurrent neuroplasticity facilitation techniques.Additionally,when noninvasive brain stimulation is applied for the rehabilitation of gait impairment in stroke survivors,stimulation montages should be customized according to the specific types of neuroplasticity found in each individual.This could be done using multiple mapping techniques.展开更多
Chronic abdominal and pelvic pain is a common condition that has significant impact on quality of life,and causes billions of dollars in direct and indirect costs.Emerging data suggest that transcranial direct current...Chronic abdominal and pelvic pain is a common condition that has significant impact on quality of life,and causes billions of dollars in direct and indirect costs.Emerging data suggest that transcranial direct current stimulation(t DCS),alone or in combination with transcutaneous electrical nerve stimulation(TENS),could be a promising therapeutic avenue to reduce chronic pain.The encouraging results coming from these studies prompted us to try combining TENS and t DCS in 4 of our patients who suffered from chronic abdominal/pelvic pain and to compare the effect with 5other patients who received TENS alone.Pain intensity was assessed with a visual analog scale before,during and after the stimulation.We observed that there was a slight decrease in pain which was similar in both patient groups(TENS alone and TENS combined with t DCS).These observations suggest that combining TENS and t DCS in patients suffering from chronic pelvic and/or abdominal pain produces no additional benefit,compared to TENS alone.Future studies,looking at the effect of several/consecutive TENS and t DCS sessions should be conducted.展开更多
目的:探究功能性近红外光谱技术(functional near-infrared spectroscopy,f NIRS)动态观察经颅直流电刺激(transcranial direct current stimulation,tDCS)与功能性电刺激(functional electrical stimulation,FES)的不同时序组合治疗对...目的:探究功能性近红外光谱技术(functional near-infrared spectroscopy,f NIRS)动态观察经颅直流电刺激(transcranial direct current stimulation,tDCS)与功能性电刺激(functional electrical stimulation,FES)的不同时序组合治疗对脑卒中偏瘫患者初级运动皮质(primary motor cortex,M1)脑功能连接的即时影响。方法:采用自身对照,将15例符合入选标准的脑卒中偏瘫患者,依次给予单纯tDCS治疗、单纯FES治疗、tDCS和FES同步治疗、先tDCS后FES时序治疗,每种干预各1次,洗脱期为2天。干预前后进行f NIRS检测,静息态脑功能连接(resting state functional connectivity,RSFC)采用相关分析和基于图论的复杂网络分析。利用NIRS-SPM工具包计算不同干预下氧合血红蛋白的脑激活图。结果:发现单纯FES治疗、tDCS+FES同步治疗、tDCSFES时序治疗下激活脑区显著于单纯tDCS治疗(P=0.023),而tDCSFES时序治疗下脑区激活显著于单纯FES治疗和tDCS+FES同步治疗组(P<0.05)。相关分析发现不同治疗方法下运动区相关皮质FC均较干预前增多,依次为tDCSFES时序治疗、单纯FES治疗、FES+tDCS同步治疗、单纯tDCS治疗。图论分析显示单纯tDCS或FES治疗在局部/全局网络效率、小世界方面程度相似,tDCS+FES同步治疗可一定程度改善脑区连接效率优于单纯电刺激治疗,tDCSFES时序治疗在改善脑区域连接效率方面最明显。结论:tDCS或FES的单纯或联合治疗均能不同程度增强患者的脑功能连接和效率,提高患者的运动皮质兴奋性,但建议临床多采用tDCSFES时序治疗,有助于促进运动区脑神经功能连接。展开更多
文摘Neurological disorders with symptoms such as chronic pain,depression,and insomnia are widespread.Very weak electric fields applied through the skull can enhance or diminish neural activity and modulate brain waves in order to treat many of these common medical problems.This approach is to be contrasted with well-established pharmacological methods or more recent invasive electrical Deep Brain Stimulation(DBS)techniques that require surgery to insert electrodes deep into the brain.We claim that Non-Invasive Brain Stimulation(NIBS)will provide new treatment methods with much greater simplicity,lower cost,improved safety and in some cases,possibly greater effectiveness.This emerging use of NIBS is a branch of a new multidisciplinary field that we coined Neuro-systems Engineering[1].This field involves neuroscientists,psychologists,and electrical engineers.This emerging field relies on existing standards for the safe implementation of these novel treatment modalities[2].Methods of stimulating the brain are based on emerging electro-technologies such as transcranial Direct Current/Alternating Current(DC/AC)electric fields and pulsed magnetic fields.Application of functional and time-dependent brain imaging methods can be used to locate relevant brain regions and determine the most appropriate stimulation method.Application of tailored and individualized control can be combined with other therapy methods to effectively treat neurological disorders while minimizing or even eliminating the use of pharmaceuticals.In this paper,we are presenting our embodiment for a closed loop,feedback controlled,non-invasive application of electrical stimulation of the brain to enhance individual/group performance or to treat neurological disorders.
基金supported by the National Natural Science Foundation of China,No.30973165,81372108a grant from Clinical Research 5010 Program Mission Statement of Sun Yat-Sen University,China,No.2014001
文摘Gait disorders drastically affect the quality of life of stroke survivors,making post-stroke rehabilitation an important research focus.Noninvasive brain stimulation has potential in facilitating neuroplasticity and improving post-stroke gait impairment.However,a large inter-individual variability in the response to noninvasive brain stimulation interventions has been increasingly recognized.We first review the neurophysiology of human gait and post-stroke neuroplasticity for gait recovery,and then discuss how noninvasive brain stimulation techniques could be utilized to enhance gait recovery.While post-stroke neuroplasticity for gait recovery is characterized by use-dependent plasticity,it evolves over time,is idiosyncratic,and may develop maladaptive elements.Furthermore,noninvasive brain stimulation has limited reach capability and is facilitative-only in nature.Therefore,we recommend that noninvasive brain stimulation be used adjunctively with rehabilitation training and other concurrent neuroplasticity facilitation techniques.Additionally,when noninvasive brain stimulation is applied for the rehabilitation of gait impairment in stroke survivors,stimulation montages should be customized according to the specific types of neuroplasticity found in each individual.This could be done using multiple mapping techniques.
基金the Fonds de recherche en santédu Québec(FRQS)No.29182
文摘Chronic abdominal and pelvic pain is a common condition that has significant impact on quality of life,and causes billions of dollars in direct and indirect costs.Emerging data suggest that transcranial direct current stimulation(t DCS),alone or in combination with transcutaneous electrical nerve stimulation(TENS),could be a promising therapeutic avenue to reduce chronic pain.The encouraging results coming from these studies prompted us to try combining TENS and t DCS in 4 of our patients who suffered from chronic abdominal/pelvic pain and to compare the effect with 5other patients who received TENS alone.Pain intensity was assessed with a visual analog scale before,during and after the stimulation.We observed that there was a slight decrease in pain which was similar in both patient groups(TENS alone and TENS combined with t DCS).These observations suggest that combining TENS and t DCS in patients suffering from chronic pelvic and/or abdominal pain produces no additional benefit,compared to TENS alone.Future studies,looking at the effect of several/consecutive TENS and t DCS sessions should be conducted.
文摘目的:探究功能性近红外光谱技术(functional near-infrared spectroscopy,f NIRS)动态观察经颅直流电刺激(transcranial direct current stimulation,tDCS)与功能性电刺激(functional electrical stimulation,FES)的不同时序组合治疗对脑卒中偏瘫患者初级运动皮质(primary motor cortex,M1)脑功能连接的即时影响。方法:采用自身对照,将15例符合入选标准的脑卒中偏瘫患者,依次给予单纯tDCS治疗、单纯FES治疗、tDCS和FES同步治疗、先tDCS后FES时序治疗,每种干预各1次,洗脱期为2天。干预前后进行f NIRS检测,静息态脑功能连接(resting state functional connectivity,RSFC)采用相关分析和基于图论的复杂网络分析。利用NIRS-SPM工具包计算不同干预下氧合血红蛋白的脑激活图。结果:发现单纯FES治疗、tDCS+FES同步治疗、tDCSFES时序治疗下激活脑区显著于单纯tDCS治疗(P=0.023),而tDCSFES时序治疗下脑区激活显著于单纯FES治疗和tDCS+FES同步治疗组(P<0.05)。相关分析发现不同治疗方法下运动区相关皮质FC均较干预前增多,依次为tDCSFES时序治疗、单纯FES治疗、FES+tDCS同步治疗、单纯tDCS治疗。图论分析显示单纯tDCS或FES治疗在局部/全局网络效率、小世界方面程度相似,tDCS+FES同步治疗可一定程度改善脑区连接效率优于单纯电刺激治疗,tDCSFES时序治疗在改善脑区域连接效率方面最明显。结论:tDCS或FES的单纯或联合治疗均能不同程度增强患者的脑功能连接和效率,提高患者的运动皮质兴奋性,但建议临床多采用tDCSFES时序治疗,有助于促进运动区脑神经功能连接。
