Revisiting subcallosal cingulate deep brain stimulation for depression: Long-term safety and effectiveness outcomes from a pooled analysis of 172 implanted patients.

Objective: Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) has been investigated clinically for treatment-resistant depression (TRD). Although the initial BROADEN study, a randomized controlled trial, was halted after an interim futility analysis, observation of long-term follow-up (LTFU) data from this and other cohorts demonstrated sustained improvement in depressive symptoms, prompting further investigation of DBS as a therapeutic option.

Methods: Data from 5 studies, including BROADEN, were used to evaluate the long-term safety and effectiveness of SCC DBS for TRD.

Neurosurgical Techniques for Chronic Pain in Adult Cancer Survivors.

Background: Chronic pain is a prevalent and often undertreated issue for adult cancer survivors, lasting well beyond the completion of curative treatment or during prolonged maintenance therapy. Historically, pain management in this population has followed strategies similar to those used for active cancer pain - primarily systemic opioids - despite the long-term risks of functional decline, endocrine disruption, and misuse during periods of survivorship that may span decades.

Summary: This review examines the evolving role of neuromodulatory and functional neurosurgical interventions for chronic pain in adult cancer survivors.

5-Aminolevulonic Acid, a New Tumor Contrast Agent: Anesthesia Considerations in Patients Undergoing Craniotomy.

5-aminolevulinic acid (ALA) is used during resection of malignant gliomas due to its fluorescence properties and has been shown to render resection more effective than resection without ALA guidance. The aim of this narrative review is to categorize the adverse effects of ALA relevant to anesthesia providers. Intraoperative hypotension, porphyria-related side effects, alterations in blood chemistry and coagulation, photosensitivity, and increased levels of liver enzymes have all been reported.

Vagus Nerve Stimulation in Stroke Management: Brief Review of Evolution and Present Applications Paired with Rehabilitation.

Cerebrovascular accident (CVA) or stroke is a devastating neurological condition with dismal prognosis associated with recurrent episodes that further damage the neuronal networks, thus disabling neuronal plasticity. Vagus nerve stimulation (VNS) has been used in clinical practice to treat epilepsy for several decades and is well accepted as a safe procedure devoid of serious adverse events. Bailey and Bremer demonstrated that VNS has the capabilities to stimulate neuronal pathways that enhance the recovery of damaged cerebral function.

Efficacy and safety of transcranial direct current stimulation (tDCS) in patients with obsessive-compulsive disorder (OCD): A systematic review and meta-analysis of randomized controlled trials.

Background: Transcranial direct current stimulation (tDCS) is gaining traction for treating obsessive-compulsive disorder (OCD), but its effectiveness and safety remain uncertain. A systematic review of randomized controlled trials (RCTs) will assess its clinical benefits for symptom reduction.

Methods: Six databases-Scopus, PubMed, Web of Science, Cochrane, PsycINFO, and Cochrane Central-were searched to identify relevant studies.

Altius electrical nerve stimulation for post-amputation pain treatment: a comprehensive review.

Post-amputation pain (PAP), which includes both residual limb and phantom limb pain, affects up to 85% of amputees and severely impairs quality of life, mobility, and psychological well-being while incurring substantial healthcare costs. Conventional treatments - pharmacotherapy and neuromodulation techniques such as spinal cord stimulation and peripheral nerve stimulation - often provide inadequate relief and are associated with adverse effects like opioid dependence and systemic toxicity. The Altius High-Frequency Nerve Block System is an innovative therapeutic approach that delivers high-frequency alternating current (HFAC) directly to peripheral nerves, inducing a reversible conduction block without paresthesia.

Development of an Educational Curriculum for Implanting and Managing Vagus Nerve Stimulators for Epilepsy.

Background: Vagus nerve stimulation (VNS) devices are commonly used for extracranial neuromodulation of drug-resistant epilepsy. These devices are implanted by multiple surgical subspecialties and managed by practitioners with varying levels of epilepsy-specific expertise. The North American Neuromodulation Society (NANS) education committee presents a curriculum defining level-dependent recommendations within the six-core competency rubric for the implantation and management of VNS devices.

Long-Term Effects of Spinal Cord Stimulation on Pain in Postherpetic Neuralgia.

Introduction: Postherpetic neuralgia (PHN) is a pain syndrome that develops within few months after the acute herpetic outbreak. The pain may be accompanied by specific cutaneous signs in the distribution of affected dermatomes and feel unbearable reaching up to 9-10/10 on visual analog scale (VAS). Despite the introduction of new medications, drug resistance develops in at least 50% of cases.

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.

Focused ultrasound for treatment of epilepsy: a systematic review and meta-analysis of preclinical and clinical studies.

Various preclinical and clinical studies have demonstrated the neuromodulatory and ablative effects of focused ultrasound (FUS). However, the safety and efficacy of FUS in clinical settings for treating epilepsy have not been well established. This study aims to provide a systematic review of all preclinical and clinical studies that have used FUS for the treatment of epilepsy.

The Opinion of Healthcare Professionals About a Proposed European Registry of Neuromodulation for Chronic Pain: An Online Survey.

Introduction: During the last decade, the complementary value of real-world data (through registries or medical records) and data from randomized clinical trials has been recognized as increasingly important. In the field of neuromodulation, only a few industry-independent nationwide neuromodulation registries are available. The interest in creating a European registry has increased but without a successful result.

Long-Term Treatment of Chronic Postamputation Pain With Bioelectric Nerve Block: Twelve-Month Results of the Randomized, Double-Blinded, Cross-Over QUEST Study.

Objective: The multicenter, randomized, double-blinded, active-sham controlled trial (high-freQUEncy nerve block for poST amputation pain [QUEST]) was conducted to show the safety and efficacy of a novel, peripherally placed high-frequency nerve block (HFNB) system in treating chronic postamputation pain (PAP) in patients with lower limb amputations. The primary outcomes from QUEST were reported previously. This study presents the long-term, single-cross-over, secondary outcomes of on-demand HFNB treatment for chronic PAP.

Awake versus asleep deep brain stimulation for Parkinson's disease: a comprehensive systematic review and meta-analysis.

Objective: Deep brain stimulation (DBS) has become an effective and safe treatment in patients with Parkinson's disease (PD) not responding to conventional treatments. With the growing body of literature regarding the use of DBS in different movement disorders, there remain controversies regarding performing awake or asleep DBS. This systematic review provides the most comprehensive review of the literature comparing the two techniques from various aspects in detail.

Electrical stimulation enhances sciatic nerve regeneration using a silk-based conductive scaffold beyond traditional nerve guide conduits.

Despite recent advancements in peripheral nerve regeneration, the creation of nerve conduits with chemical and physical cues to enhance glial cell function and support axonal growth remains challenging. This study aimed to assess the impact of electrical stimulation (ES) using a conductive nerve conduit on sciatic nerve regeneration in a rat model with transection injury. The study involved the fabrication of conductive nerve conduits using silk fibroin and Au nanoparticles (AuNPs).

Primary 3-Month Outcomes of a Double-Blind Randomized Prospective Study (The QUEST Study) Assessing Effectiveness and Safety of Novel High-Frequency Electric Nerve Block System for Treatment of Post-Amputation Pain.

Purpose: This multicenter, randomized, double-blinded, active sham-controlled pivotal study was designed to assess the efficacy and safety of high-frequency nerve block treatment for chronic post-amputation and phantom limb pain.

Patients And Methods: QUEST enrolled 180 unilateral lower-limb amputees with severe post-amputation pain, 170 of whom were implanted with the Altius device, were randomized 1:1 to active-sham or treatment groups and reached the primary endpoint. Responders were those subjects who received ≥50% pain relief 30 min after treatment in ≥50% of their self-initiated treatment sessions within the 3-month randomized period.

Systems Neuroscience's 2022 Top Papers: An Editorial Summary.

Despite the seemingly endless-and sometimes overwhelming-flow of scientific information, there are always some articles that stand out from the crowd, either due to the depth of the covered topic, or due to their unique and unexpected findings [...

Magnetic resonance imaging of radiofrequency thalamotomy for tremor: what is it about?

This scientific commentary refers to 'Radiofrequency thalamotomy for tremor produces focused and predictable lesions shown on magnetic resonance images', by Ishihara . (https://doi.org/10.

Drug-Free Noninvasive Thermal Nerve Block: Validation of Sham Devices.

Headache is a leading cause of disability and suffering. One major challenge in developing device treatments is demonstrating their efficacy given devices' often-high placebo rate. This paper reviews the importance of validating sham devices as part of finalizing the design for larger-scale prospective randomized controlled trials in patients with chronic headache as well as the results of a prospective, single-blind trial to validate two potential sham noninvasive thermal nerve block devices.