Spinal cord injury is a severe neurological disorder;however,current treatment methods often fail to restore nerve function effectively.Spinal cord stimulation via electrical signals is a promising therapeutic modalit...Spinal cord injury is a severe neurological disorder;however,current treatment methods often fail to restore nerve function effectively.Spinal cord stimulation via electrical signals is a promising therapeutic modality for spinal cord injury.Based on similar principles,this review aims to explore the potential of optical and acoustic neuromodulation techniques,emphasizing their benefits in the context of spinal cord injury.Photoacoustic imaging,renowned for its noninvasive nature,high-resolution capabilities,and cost-effectiveness,is well recognized for its role in early diagnosis,dynamic monitoring,and surgical guidance in stem cell therapies for spinal cord injury.Moreover,photoacoustodynamic therapy offers multiple pathways for tissue regeneration.Optogenetics and sonogenetics use genetic engineering to achieve precise neuronal activation,while photoacoustoelectric therapy leverages photovoltaic materials for electrical modulation of the nervous system,introducing an innovative paradigm for nerve system disorder management.Collectively,these advancements represent a transformative shift in the diagnosis and treatment of spinal cord injury,with the potential to significantly enhance nerve function remodeling and improve patient outcomes.展开更多
Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functio...Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.展开更多
Neuromodulation for diabetic peripheral neuropathy represents a significant area of interest in the management of chronic pain associated with this condition.Diabetic peripheral neuropathy,a common complication of dia...Neuromodulation for diabetic peripheral neuropathy represents a significant area of interest in the management of chronic pain associated with this condition.Diabetic peripheral neuropathy,a common complication of diabetes,is characterized by nerve damage due to high blood sugar levels that lead to symptoms,such as pain,tingling,and numbness,primarily in the hands and feet.The aim of this systematic review was to evaluate the efficacy of neuromodulatory techniques as potential therapeutic interventions for patients with diabetic peripheral neuropathy,while also examining recent developments in this domain.The investigation encompassed an array of neuromodulation methods,including frequency rhythmic electrical modulated systems,dorsal root ganglion stimulation,and spinal cord stimulation.This systematic review suggests that neuromodulatory techniques may be useful in the treatment of diabetic peripheral neuropathy.Understanding the advantages of these treatments will enable physicians and other healthcare providers to offer additional options for patients with symptoms refractory to standard pharmacologic treatments.Through these efforts,we may improve quality of life and increase functional capacity in patients suffering from complications related to diabetic neuropathy.展开更多
Zhang et al delivered a paradigm-shifting understanding of electroacupuncture(EA)’s action in diabetic gastroparesis through a well-defined vagal pathway.Their work bridged traditional acupuncture and modern neurogas...Zhang et al delivered a paradigm-shifting understanding of electroacupuncture(EA)’s action in diabetic gastroparesis through a well-defined vagal pathway.Their work bridged traditional acupuncture and modern neurogastroenterology,highlighting EA as a viable strategy for refractory diabetic gastroparesis.The study integrated electrophysiology(gastric slow-wave recordings),functional assays(phenol red gastric emptying,and intestinal propulsion),dynamic positron emission tomography/computed tomography imaging,histopathology,and molecular biology(Western blot,immunofluorescence,and enzyme-linked immunosorbent assay).This comprehensive approach robustly confirmed EA’s efficacy in restoring gastric motility,interstitial cells of Cajal function,and neuropeptide balance.Future studies should prioritize clinical translation and explore synergies with pharmacological agents.展开更多
Depression is a multifaceted disorder with a largely unresolved etiology influenced by a complex interplay of pathogenic factors.Despite decades of research,it remains a major condition that significantly diminishes p...Depression is a multifaceted disorder with a largely unresolved etiology influenced by a complex interplay of pathogenic factors.Despite decades of research,it remains a major condition that significantly diminishes patients’quality of life.Advances in optogenetics have introduced a powerful tool for exploring the neural mechanisms underlying depression.By selectively expressing optogenes in specific cell types in mice,researchers can study the roles of these cells through targeted light stimulation,offering new insights into central nervous system disorders.The use of viral vectors to express opsins in distinct neuronal subtypes enables precise activation or inhibition of these neurons via light.When combined with behavioral,morphological,and electrophysiological analyses,optogenetics provides an invaluable approach to investigating the neural mechanisms of psychiatric conditions.This review synthesizes current research on the application of optogenetics to understand the mechanisms of depression.This study aims to enhance our knowledge of optogenetic strategies for regulating depression and advancing antidepressant research.展开更多
Dysfunction of the interoceptive system is recognized as an important component of clinical symptoms,including anxiety,depression,psychosis,and other mental disorders.Non-invasive neuromodulation is an emerging clinic...Dysfunction of the interoceptive system is recognized as an important component of clinical symptoms,including anxiety,depression,psychosis,and other mental disorders.Non-invasive neuromodulation is an emerging clinical intervention approach,and over the past decade,research on non-invasive neuromodulation aimed at regulating interoception has rapidly developed.This review first outlines the pathways of interoceptive signals and assessment methods,then summarizes the interoceptive abnormalities in psychiatric disorders and current studies for non-invasive neuromodulation targeting interoception,including intervention modes,target sites,interoceptive measures,and potential neurobiological mechanisms.Finally,we discuss significant research challenges and future directions.展开更多
γ neuromodulation has emerged as a promising strategy for addressing neurological and psychiatric disorders,particularly in regulating executive and cognitive functions.This review explores the latest neuromodulation...γ neuromodulation has emerged as a promising strategy for addressing neurological and psychiatric disorders,particularly in regulating executive and cognitive functions.This review explores the latest neuromodulation techniques,focusing on the critical role of γ oscillations in various brain disorders.Direct γ neuromodulation induces γ -frequency oscillations to synchronize disrupted brain networks,while indirect methods influence γ oscillations by modulating cortical excitability.We investigate how monitoring dynamic features of γ oscillations allows for detailed evaluations of neuromodulation effectiveness.By targeting γ oscillatory patterns and restoring healthy cross-frequency coupling,interventions may alleviate cognitive and behavioral symptoms linked to disrupted communication.This review examines clinical applications of γ neuromodulations,including enhancing cognitive function through 40 Hz multisensory stimulation in Alzheimer’s disease,improving motor function in Parkinson’s disease,controlling seizures in epilepsy,and modulating emotional dysfunctions in depression.Additionally,these neuromodulation strategies aim to regulate excitatory-inhibitory imbalances and restore γ synchrony across neurological and psychiatric disorders.The review highlights the potential of γ oscillations as biomarkers to boost restorative results in clinical applications of neuromodulation.Future studies might focus on integrating multimodal personalized protocols,artificial intelligence(AI)driven frameworks for neural decoding,and global multicenter collaborations to standardize and scale precision treatments across diverse disorders.展开更多
Cognitive enhancement is essential for maintaining the quality of life in healthy individuals and improving the ability of those with mental impairments.In recent years,noninvasive neuromodulation techniques(such as t...Cognitive enhancement is essential for maintaining the quality of life in healthy individuals and improving the ability of those with mental impairments.In recent years,noninvasive neuromodulation techniques(such as transcranial magnetic stimulation,transcranial direct-current stimulation,and transcranial ultrasound stimulation)have shown significant potential in enhancing cognitive functions[1,2].Existing technologies are limited mainly to superficial cortical regions,with limited efficacy in targeting deep brain areas and inadequate methods for evaluating their modulatory effects.Selecting stimulation parameters(such as locus,depth,and intensity)and assessing the impact of neuromodulation remains incompletely understood.展开更多
Optogenetics,a technique that employs light for neuromodulation,has revolutionized the study of neural mechanisms and the treatment of neurological disorders due to its high spatiotemporal resolution and cell-type spe...Optogenetics,a technique that employs light for neuromodulation,has revolutionized the study of neural mechanisms and the treatment of neurological disorders due to its high spatiotemporal resolution and cell-type specificity.However,visible light,particularly blue and green light,commonly used in conventional optogenetics,has limited penetration in biological tissue.This limitation necessitates the implantation of optical fibers for light delivery,especially in deep brain regions,leading to tissue damage and experimental constraints.To overcome these challenges,the use of orange-red and infrared light with greater tissue penetration has emerged as a promising approach for tetherless optical neuromodulation.In this review,we provide an overview of the development and applications of tetherless optical neuromodulation methods with long wavelengths.We first discuss the exploration of orange-red wavelength-responsive rhodopsins and their performance in tetherless optical neuromodulation.Then,we summarize two novel tetherless neuromodulation methods using near-infrared light:upconversion nanoparticle-mediated optogenetics and photothermal neuromodulation.In addition,we discuss recent advances in mid-infrared optical neuromodulation.展开更多
Inflammatory bowel disease(IBD)is an inflammatory disease of the gastrointestinal(GI)tract.It has financial and quality of life impact on patients.Although there has been a significant advancement in treatments,a cons...Inflammatory bowel disease(IBD)is an inflammatory disease of the gastrointestinal(GI)tract.It has financial and quality of life impact on patients.Although there has been a significant advancement in treatments,a considerable number of patients do not respond to it or have severe side effects.Therapeutic approaches such as electrical neuromodulation are being investigated to provide alternate options.Although bioelectric neuromodulation technology has evolved significantly in the last decade,sacral nerve stimulation(SNS)for fecal incontinence remains the only neuromodulation protocol commonly utilized use for GI disease.For IBD treatment,several electrical neuromodulation techniques have been studied,such as vagus NS,SNS,and tibial NS.Several animal and clinical experiments were conducted to study the effectiveness,with encouraging results.The precise underlying mechanisms of action for electrical neuromodulation are unclear,but this modality appears to be promising.Randomized control trials are required to investigate the efficacy of intrinsic processes.In this review,we will discuss the electrical modulation therapy for the IBD and the data pertaining to it.展开更多
Spinal cord injury is linked to the interruption of neural pathways,which results in irreversible neural dysfunction.Neural repair and neuroregeneration are critical goals and issues for rehabilitation in spinal cord ...Spinal cord injury is linked to the interruption of neural pathways,which results in irreversible neural dysfunction.Neural repair and neuroregeneration are critical goals and issues for rehabilitation in spinal cord injury,which require neural stem cell repair and multimodal neuromodulation techniques involving personalized rehabilitation strategies.Besides the involvement of endogenous stem cells in neurogenesis and neural repair,exogenous neural stem cell transplantation is an emerging effective method for repairing and replacing damaged tissues in central nervous system diseases.However,to ensure that endogenous or exogenous neural stem cells truly participate in neural repair following spinal cord injury,appropriate interventional measures(e.g.,neuromodulation)should be adopted.Neuromodulation techniques,such as noninvasive magnetic stimulation and electrical stimulation,have been safely applied in many neuropsychiatric diseases.There is increasing evidence to suggest that neuromagnetic/electrical modulation promotes neuroregeneration and neural repair by affecting signaling in the nervous system;namely,by exciting,inhibiting,or regulating neuronal and neural network activities to improve motor function and motor learning following spinal cord injury.Several studies have indicated that fine motor skill rehabilitation training makes use of residual nerve fibers for collateral growth,encourages the formation of new synaptic connections to promote neural plasticity,and improves motor function recovery in patients with spinal cord injury.With the development of biomaterial technology and biomechanical engineering,several emerging treatments have been developed,such as robots,brain-computer interfaces,and nanomaterials.These treatments have the potential to help millions of patients suffering from motor dysfunction caused by spinal cord injury.However,large-scale clinical trials need to be conducted to validate their efficacy.This review evaluated the efficacy of neural stem cells and magnetic or electrical stimulation combined with rehabilitation training and intelligent therapies for spinal cord injury according to existing evidence,to build up a multimodal treatment strategy of spinal cord injury to enhance nerve repair and regeneration.展开更多
Tinnitus is defined as a perception of sound without any external sound source.Chronic tinnitus is a frequent condition that can affect the quality of life.So far,no causal cure for tinnitus has been documented,and mo...Tinnitus is defined as a perception of sound without any external sound source.Chronic tinnitus is a frequent condition that can affect the quality of life.So far,no causal cure for tinnitus has been documented,and most pharmacologic and psychosomatic treatment modalities aim to diminish tinnitus’impact on the quality of life.Neuromodulation,a novel therapeutic modality,which aims at alternating nerve activity through a targeted delivery of a stimulus,has emerged as a potential option in tinnitus treatment.This review provides a brief overview of the current neuromodulation techniques as tinnitus treatment options.The main intention is to provide updated knowledge especially for medical professionals counselling tinnitus patients in this emerging field of medicine.Non-invasive methods such as repetitive transcranial magnetic stimulation,transcranial electrical stimulation,neurofeedback,and transcutaneous vagus nerve stimulation were included,as well as invasive methods such as implanted vagus nerve stimulation and invasive brain stimulation.Some of these neuromodulation techniques revealed promising results;nevertheless,further research is needed,especially regarding the pathophysiological principle as to how these neuromodulation techniques work and what neuronal change they induce.Various studies suggest that individually different brain states and networks are involved in the generation and perception of tinnitus.Therefore,in the future,individually tailored neuromodulation strategies could be a promising approach in tinnitus treatment for achieving a more substantial and longer lasting improvement of complaints.展开更多
Non-invasive cerebral neuromodulation technologies are essential for the reorganization of cerebral neural networks,which have been widely applied in the field of central neurological diseases,such as stroke,Parkinson...Non-invasive cerebral neuromodulation technologies are essential for the reorganization of cerebral neural networks,which have been widely applied in the field of central neurological diseases,such as stroke,Parkinson’s disease,and mental disorders.Although significant advances have been made in neuromodulation technologies,the identification of optimal neurostimulation paramete rs including the co rtical target,duration,and inhibition or excitation pattern is still limited due to the lack of guidance for neural circuits.Moreove r,the neural mechanism unde rlying neuromodulation for improved behavioral performance remains poorly understood.Recently,advancements in neuroimaging have provided insight into neuromodulation techniques.Functional near-infrared spectroscopy,as a novel non-invasive optical brain imaging method,can detect brain activity by measuring cerebral hemodynamics with the advantages of portability,high motion tole rance,and anti-electromagnetic interference.Coupling functional near-infra red spectroscopy with neuromodulation technologies offe rs an opportunity to monitor the cortical response,provide realtime feedbac k,and establish a closed-loop strategy integrating evaluation,feedbac k,and intervention for neurostimulation,which provides a theoretical basis for development of individualized precise neuro rehabilitation.We aimed to summarize the advantages of functional near-infra red spectroscopy and provide an ove rview of the current research on functional near-infrared spectroscopy in transcranial magnetic stimulation,transcranial electrical stimulation,neurofeedback,and braincomputer interfaces.Furthermore,the future perspectives and directions for the application of functional near-infrared spectroscopy in neuromodulation are summarized.In conclusion,functional near-infrared spectroscopy combined with neuromodulation may promote the optimization of central pellral reorganization to achieve better functional recovery form central nervous system diseases.展开更多
Stem cell transplantation holds a promising future for central nervous system repair. Current challenges, however, include spatially and temporally defined cell differentiation and maturation, plus the integration of ...Stem cell transplantation holds a promising future for central nervous system repair. Current challenges, however, include spatially and temporally defined cell differentiation and maturation, plus the integration of transplanted neural cells into host circuits. Here we discuss the potential advantages of neuromodulation-based stem cell therapy, which can improve the viability and proliferation of stem cells, guide migration to the repair site,orchestrate the differentiation process, and promote the integration of neural circuitry for functional rehabilitation.All these advantages of neuromodulation make it one potentially valuable tool for further improving the efficiency of stem cell transplantation.展开更多
BACKGROUND Management of non-neurogenic,non-obstructive dysuria represents one of the most challenging dilemmas in urological practice.The main clinical symptom is the increase in residual urine.Voiding dysfunction is...BACKGROUND Management of non-neurogenic,non-obstructive dysuria represents one of the most challenging dilemmas in urological practice.The main clinical symptom is the increase in residual urine.Voiding dysfunction is the main cause of dysuria or urinary retention,mainly due to the decrease in bladder contraction(the decrease in contraction amplitude or duration)or the increase in outflow tract resistance.Sacral neuromodulation(SNM)has been used for>10 years to treat many kinds of lower urinary tract dysfunction.It has become increasingly popular in China in recent years.Consequently,studies focusing on nonneurogenic,non-obstructive dysuria patients treated by SNM are highly desirable.AIM To assess the outcome of two-stage SNM in non-neurogenic,non-obstructive dysuria.METHODS Clinical data of 54 patients(26 men,28 women)with non-neurogenic,nonobstructive dysuria treated by SNM from January 2012 to December 2016 in ten medical centers in China were retrospectively analyzed.All patients received two or more conservative treatments.The voiding diary,urgency score,and quality of life score before operation,after implantation of tined lead in stage I(test period),and during short-term follow-up(latest follow-up)after implantation of the implanted pulse generator in stage II were compared to observe symptom improvements.RESULTS Among the 54 study patients,eight refused to implant an implanted pulse generator because of the unsatisfactory effect,and 46 chose to embed the implanted pulse generator at the end of stage I.The conversion rate of stage I to stage II was 85.2%.The average follow-up time was 18.6 mo.There were significant differences between baseline(before stage I)and the test period(after stage I)in residual urine,voiding frequency,average voiding amount,maximum voiding amount,nocturia,urgency score,and quality of life score.The residual urine and urgency score between the test period and the latest follow-up time(after stage II)were also significantly different.No significant differences were observed for other parameters.No wound infection,electrode breakage,or other irreversible adverse events occurred.CONCLUSION SNM is effective for patients with non-neurogenic,non-obstructive dysuria showing a poor response to traditional treatment.The duration of continuous stimulation may be positively correlated with the improvement of residual urine.展开更多
Fecal incontinence is a disabling symptom with medical and social implications,including fear,embarrassment,isolation and even depression.Most patients live in seclusion and have to plan their life around the symptom,...Fecal incontinence is a disabling symptom with medical and social implications,including fear,embarrassment,isolation and even depression.Most patients live in seclusion and have to plan their life around the symptom,with secondary impairment of their quality of life.Conservative management and biofeedback therapy are reported to benefit a good percentage of those affected.However,surgery must be considered in the nonresponder population.Recently,sacral nerve electrostimulation,lately named neuromodulation,has been reported to benefit patients with fecal incontinence in randomized controlled trials more than placebo stimulation and conservative management,by some unknown mechanism.Neuromodulation is a minimally invasive procedure with a low rate of adverse events and apparently favorable cost-efficacy profile.This review is intended to expand knowledge about this effective intervention among the non-surgically skilled community who deals with this disabled group of patients.展开更多
Vision altering diseases,such as glaucoma,diabetic retinopathy,age-related macular degeneration,myopia,retinal vascular disease,traumatic brain injuries and others cripple many lives and are projected to continue to c...Vision altering diseases,such as glaucoma,diabetic retinopathy,age-related macular degeneration,myopia,retinal vascular disease,traumatic brain injuries and others cripple many lives and are projected to continue to cause anguish in the foreseeable future.Gap junctions serve as an emerging target for neuromodulation and possible regeneration as they directly connect healthy and/or diseased cells,thereby playing a crucial role in pathophysiology.Since they are permeable for macromolecules,able to cross the cellular barriers,they show duality in illness as a cause and as a therapeutic target.In this review,we take recent advancements in gap junction neuromodulation(pharmacological blockade,gene therapy,electrical and light stimulation)into account,to show the gap junction’s role in neuronal cell death and the possible routes of rescuing neuronal and glial cells in the retina succeeding illness or injury.展开更多
Brain, an organ similar to a computer, is the ultimate director of the body1. This means that organs, tissues and cells are under its control and that these parts of the body do not control what happen to them. If the...Brain, an organ similar to a computer, is the ultimate director of the body1. This means that organs, tissues and cells are under its control and that these parts of the body do not control what happen to them. If the brain is functioning properly, we have health;and if it works wrongly a disease will show. Acting on the brain by neuromodulation, by means of acupuncture, homeopathy or even allopathic drugs can produce a therapeutic response. The purpose of this paper is to recognize this effect and propose a new Law of Cure which explains how several complementary and alternative medicine (CAM) systems work. In this theory, acupuncture works by stimulating peripheral sensory receptors and transmitting information to the brain which in turn will trigger a curative response to the affected organ. In this sense, acupuncture is an informatics system for a biological system, and therefore it could be considered part of the bioinformatics sciences, in the same idea that the brain is a living computer which has inputs and outputs and controls all process inside the body. In this paper we present the basis for this theory.展开更多
Objective: To review the evidence surrounding Sacral Neuromodulation therapy and delineate areas that will need more research. Methods: An extensive search was performed on the available literature on SNM for lower ur...Objective: To review the evidence surrounding Sacral Neuromodulation therapy and delineate areas that will need more research. Methods: An extensive search was performed on the available literature on SNM for lower urinary tract dysfunction. Based on the results of the search, the mechanisms of action, indications, technique, and patient characteristics of therapy failures and success are presented and discussed. Results: SNM is accepted by the FDA since 1997 for the treatment of lower urinary tract dysfunction. As it is a relatively new procedure, there are variations in the technique of lead placement, generator choice, testing interval, patient selection, time to explantation, and definitions of therapy failures and successes. Conclusions: SNM is a safe and therapeutic option for the treatment of urgencyfrequency syndrome, urge incontinence, and idiopathic urinary retention. However, there are multiple unanswered questions that require extensive research.展开更多
基金supported by the National Key R&D Program of China,No.2023YFC2509700the Beijing Natural Science Foundation-Haidian Original Innovation Joint Fund,No.L232141the Research and Application of Clinical Characteristic Diagnosis and Treatment Program,No.Z221100007422019(all to WD)。
文摘Spinal cord injury is a severe neurological disorder;however,current treatment methods often fail to restore nerve function effectively.Spinal cord stimulation via electrical signals is a promising therapeutic modality for spinal cord injury.Based on similar principles,this review aims to explore the potential of optical and acoustic neuromodulation techniques,emphasizing their benefits in the context of spinal cord injury.Photoacoustic imaging,renowned for its noninvasive nature,high-resolution capabilities,and cost-effectiveness,is well recognized for its role in early diagnosis,dynamic monitoring,and surgical guidance in stem cell therapies for spinal cord injury.Moreover,photoacoustodynamic therapy offers multiple pathways for tissue regeneration.Optogenetics and sonogenetics use genetic engineering to achieve precise neuronal activation,while photoacoustoelectric therapy leverages photovoltaic materials for electrical modulation of the nervous system,introducing an innovative paradigm for nerve system disorder management.Collectively,these advancements represent a transformative shift in the diagnosis and treatment of spinal cord injury,with the potential to significantly enhance nerve function remodeling and improve patient outcomes.
基金supported by the National Natural Science Foundation of China,No.82371399(to YY)the Natural Science Foundation of Jiangsu Province,No.BK20221206(to YY)+1 种基金the Young Elite Scientists Sponsorship Program of Jiangsu Province,No.TJ-2022-028(to YY)the Scientific Research Program of Wuxi Health Commission,No.Z202302(to LY)。
文摘Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.
文摘Neuromodulation for diabetic peripheral neuropathy represents a significant area of interest in the management of chronic pain associated with this condition.Diabetic peripheral neuropathy,a common complication of diabetes,is characterized by nerve damage due to high blood sugar levels that lead to symptoms,such as pain,tingling,and numbness,primarily in the hands and feet.The aim of this systematic review was to evaluate the efficacy of neuromodulatory techniques as potential therapeutic interventions for patients with diabetic peripheral neuropathy,while also examining recent developments in this domain.The investigation encompassed an array of neuromodulation methods,including frequency rhythmic electrical modulated systems,dorsal root ganglion stimulation,and spinal cord stimulation.This systematic review suggests that neuromodulatory techniques may be useful in the treatment of diabetic peripheral neuropathy.Understanding the advantages of these treatments will enable physicians and other healthcare providers to offer additional options for patients with symptoms refractory to standard pharmacologic treatments.Through these efforts,we may improve quality of life and increase functional capacity in patients suffering from complications related to diabetic neuropathy.
文摘Zhang et al delivered a paradigm-shifting understanding of electroacupuncture(EA)’s action in diabetic gastroparesis through a well-defined vagal pathway.Their work bridged traditional acupuncture and modern neurogastroenterology,highlighting EA as a viable strategy for refractory diabetic gastroparesis.The study integrated electrophysiology(gastric slow-wave recordings),functional assays(phenol red gastric emptying,and intestinal propulsion),dynamic positron emission tomography/computed tomography imaging,histopathology,and molecular biology(Western blot,immunofluorescence,and enzyme-linked immunosorbent assay).This comprehensive approach robustly confirmed EA’s efficacy in restoring gastric motility,interstitial cells of Cajal function,and neuropeptide balance.Future studies should prioritize clinical translation and explore synergies with pharmacological agents.
基金funded by the Natural Science Foundation of China(No.82305049).
文摘Depression is a multifaceted disorder with a largely unresolved etiology influenced by a complex interplay of pathogenic factors.Despite decades of research,it remains a major condition that significantly diminishes patients’quality of life.Advances in optogenetics have introduced a powerful tool for exploring the neural mechanisms underlying depression.By selectively expressing optogenes in specific cell types in mice,researchers can study the roles of these cells through targeted light stimulation,offering new insights into central nervous system disorders.The use of viral vectors to express opsins in distinct neuronal subtypes enables precise activation or inhibition of these neurons via light.When combined with behavioral,morphological,and electrophysiological analyses,optogenetics provides an invaluable approach to investigating the neural mechanisms of psychiatric conditions.This review synthesizes current research on the application of optogenetics to understand the mechanisms of depression.This study aims to enhance our knowledge of optogenetic strategies for regulating depression and advancing antidepressant research.
基金supported by grants from the National Natural Science Foundation of China(82101582)the Shanghai Science and Technology Committee(22Y11903600 and 23Y11906000)the Shanghai Municipal Health Commission(202240266).
文摘Dysfunction of the interoceptive system is recognized as an important component of clinical symptoms,including anxiety,depression,psychosis,and other mental disorders.Non-invasive neuromodulation is an emerging clinical intervention approach,and over the past decade,research on non-invasive neuromodulation aimed at regulating interoception has rapidly developed.This review first outlines the pathways of interoceptive signals and assessment methods,then summarizes the interoceptive abnormalities in psychiatric disorders and current studies for non-invasive neuromodulation targeting interoception,including intervention modes,target sites,interoceptive measures,and potential neurobiological mechanisms.Finally,we discuss significant research challenges and future directions.
基金supported by the National Natural Science Foundation of China(82401829)the Leading Innovative and Entrepreneur Team Introduction Program of Zhejiang(2023R01002).
文摘γ neuromodulation has emerged as a promising strategy for addressing neurological and psychiatric disorders,particularly in regulating executive and cognitive functions.This review explores the latest neuromodulation techniques,focusing on the critical role of γ oscillations in various brain disorders.Direct γ neuromodulation induces γ -frequency oscillations to synchronize disrupted brain networks,while indirect methods influence γ oscillations by modulating cortical excitability.We investigate how monitoring dynamic features of γ oscillations allows for detailed evaluations of neuromodulation effectiveness.By targeting γ oscillatory patterns and restoring healthy cross-frequency coupling,interventions may alleviate cognitive and behavioral symptoms linked to disrupted communication.This review examines clinical applications of γ neuromodulations,including enhancing cognitive function through 40 Hz multisensory stimulation in Alzheimer’s disease,improving motor function in Parkinson’s disease,controlling seizures in epilepsy,and modulating emotional dysfunctions in depression.Additionally,these neuromodulation strategies aim to regulate excitatory-inhibitory imbalances and restore γ synchrony across neurological and psychiatric disorders.The review highlights the potential of γ oscillations as biomarkers to boost restorative results in clinical applications of neuromodulation.Future studies might focus on integrating multimodal personalized protocols,artificial intelligence(AI)driven frameworks for neural decoding,and global multicenter collaborations to standardize and scale precision treatments across diverse disorders.
基金supported by the National Natural Science Foundation of China(82172018 and 62333002).
文摘Cognitive enhancement is essential for maintaining the quality of life in healthy individuals and improving the ability of those with mental impairments.In recent years,noninvasive neuromodulation techniques(such as transcranial magnetic stimulation,transcranial direct-current stimulation,and transcranial ultrasound stimulation)have shown significant potential in enhancing cognitive functions[1,2].Existing technologies are limited mainly to superficial cortical regions,with limited efficacy in targeting deep brain areas and inadequate methods for evaluating their modulatory effects.Selecting stimulation parameters(such as locus,depth,and intensity)and assessing the impact of neuromodulation remains incompletely understood.
基金supported by China Postdoctoral Science Foundation(2022M723356),"From 0 to 1"Original Innovation Project of the Basic Frontier Scientific Research Program of the Chinese Academy of Sciences(29J20-015-Ⅲ)Chinese Academy of Sciences 100 Talents Project:Research on Task oriented Functional Brain Development of Infants(29J20-052-Ⅲ)Natural Science Basic Research Plan in Shaanxi Province of China(2022JQ544).
文摘Optogenetics,a technique that employs light for neuromodulation,has revolutionized the study of neural mechanisms and the treatment of neurological disorders due to its high spatiotemporal resolution and cell-type specificity.However,visible light,particularly blue and green light,commonly used in conventional optogenetics,has limited penetration in biological tissue.This limitation necessitates the implantation of optical fibers for light delivery,especially in deep brain regions,leading to tissue damage and experimental constraints.To overcome these challenges,the use of orange-red and infrared light with greater tissue penetration has emerged as a promising approach for tetherless optical neuromodulation.In this review,we provide an overview of the development and applications of tetherless optical neuromodulation methods with long wavelengths.We first discuss the exploration of orange-red wavelength-responsive rhodopsins and their performance in tetherless optical neuromodulation.Then,we summarize two novel tetherless neuromodulation methods using near-infrared light:upconversion nanoparticle-mediated optogenetics and photothermal neuromodulation.In addition,we discuss recent advances in mid-infrared optical neuromodulation.
文摘Inflammatory bowel disease(IBD)is an inflammatory disease of the gastrointestinal(GI)tract.It has financial and quality of life impact on patients.Although there has been a significant advancement in treatments,a considerable number of patients do not respond to it or have severe side effects.Therapeutic approaches such as electrical neuromodulation are being investigated to provide alternate options.Although bioelectric neuromodulation technology has evolved significantly in the last decade,sacral nerve stimulation(SNS)for fecal incontinence remains the only neuromodulation protocol commonly utilized use for GI disease.For IBD treatment,several electrical neuromodulation techniques have been studied,such as vagus NS,SNS,and tibial NS.Several animal and clinical experiments were conducted to study the effectiveness,with encouraging results.The precise underlying mechanisms of action for electrical neuromodulation are unclear,but this modality appears to be promising.Randomized control trials are required to investigate the efficacy of intrinsic processes.In this review,we will discuss the electrical modulation therapy for the IBD and the data pertaining to it.
基金supported by the Major International(Regional)Joint Research Project of the National Natural Science Foundation of China,No.81820108013(to LMC)the General Research Project of the National Natural Science Foundation of China,No.81772453(to DSX)the National Key Research and Development Program of China,No.2016YFA0100800(to LMC)
文摘Spinal cord injury is linked to the interruption of neural pathways,which results in irreversible neural dysfunction.Neural repair and neuroregeneration are critical goals and issues for rehabilitation in spinal cord injury,which require neural stem cell repair and multimodal neuromodulation techniques involving personalized rehabilitation strategies.Besides the involvement of endogenous stem cells in neurogenesis and neural repair,exogenous neural stem cell transplantation is an emerging effective method for repairing and replacing damaged tissues in central nervous system diseases.However,to ensure that endogenous or exogenous neural stem cells truly participate in neural repair following spinal cord injury,appropriate interventional measures(e.g.,neuromodulation)should be adopted.Neuromodulation techniques,such as noninvasive magnetic stimulation and electrical stimulation,have been safely applied in many neuropsychiatric diseases.There is increasing evidence to suggest that neuromagnetic/electrical modulation promotes neuroregeneration and neural repair by affecting signaling in the nervous system;namely,by exciting,inhibiting,or regulating neuronal and neural network activities to improve motor function and motor learning following spinal cord injury.Several studies have indicated that fine motor skill rehabilitation training makes use of residual nerve fibers for collateral growth,encourages the formation of new synaptic connections to promote neural plasticity,and improves motor function recovery in patients with spinal cord injury.With the development of biomaterial technology and biomechanical engineering,several emerging treatments have been developed,such as robots,brain-computer interfaces,and nanomaterials.These treatments have the potential to help millions of patients suffering from motor dysfunction caused by spinal cord injury.However,large-scale clinical trials need to be conducted to validate their efficacy.This review evaluated the efficacy of neural stem cells and magnetic or electrical stimulation combined with rehabilitation training and intelligent therapies for spinal cord injury according to existing evidence,to build up a multimodal treatment strategy of spinal cord injury to enhance nerve repair and regeneration.
文摘Tinnitus is defined as a perception of sound without any external sound source.Chronic tinnitus is a frequent condition that can affect the quality of life.So far,no causal cure for tinnitus has been documented,and most pharmacologic and psychosomatic treatment modalities aim to diminish tinnitus’impact on the quality of life.Neuromodulation,a novel therapeutic modality,which aims at alternating nerve activity through a targeted delivery of a stimulus,has emerged as a potential option in tinnitus treatment.This review provides a brief overview of the current neuromodulation techniques as tinnitus treatment options.The main intention is to provide updated knowledge especially for medical professionals counselling tinnitus patients in this emerging field of medicine.Non-invasive methods such as repetitive transcranial magnetic stimulation,transcranial electrical stimulation,neurofeedback,and transcutaneous vagus nerve stimulation were included,as well as invasive methods such as implanted vagus nerve stimulation and invasive brain stimulation.Some of these neuromodulation techniques revealed promising results;nevertheless,further research is needed,especially regarding the pathophysiological principle as to how these neuromodulation techniques work and what neuronal change they induce.Various studies suggest that individually different brain states and networks are involved in the generation and perception of tinnitus.Therefore,in the future,individually tailored neuromodulation strategies could be a promising approach in tinnitus treatment for achieving a more substantial and longer lasting improvement of complaints.
文摘Non-invasive cerebral neuromodulation technologies are essential for the reorganization of cerebral neural networks,which have been widely applied in the field of central neurological diseases,such as stroke,Parkinson’s disease,and mental disorders.Although significant advances have been made in neuromodulation technologies,the identification of optimal neurostimulation paramete rs including the co rtical target,duration,and inhibition or excitation pattern is still limited due to the lack of guidance for neural circuits.Moreove r,the neural mechanism unde rlying neuromodulation for improved behavioral performance remains poorly understood.Recently,advancements in neuroimaging have provided insight into neuromodulation techniques.Functional near-infrared spectroscopy,as a novel non-invasive optical brain imaging method,can detect brain activity by measuring cerebral hemodynamics with the advantages of portability,high motion tole rance,and anti-electromagnetic interference.Coupling functional near-infra red spectroscopy with neuromodulation technologies offe rs an opportunity to monitor the cortical response,provide realtime feedbac k,and establish a closed-loop strategy integrating evaluation,feedbac k,and intervention for neurostimulation,which provides a theoretical basis for development of individualized precise neuro rehabilitation.We aimed to summarize the advantages of functional near-infra red spectroscopy and provide an ove rview of the current research on functional near-infrared spectroscopy in transcranial magnetic stimulation,transcranial electrical stimulation,neurofeedback,and braincomputer interfaces.Furthermore,the future perspectives and directions for the application of functional near-infrared spectroscopy in neuromodulation are summarized.In conclusion,functional near-infrared spectroscopy combined with neuromodulation may promote the optimization of central pellral reorganization to achieve better functional recovery form central nervous system diseases.
基金supported by the National Key R&D Program of China (No. 2020YFA0113600 and 2017YFA0105201)National Natural Sciences Foundation of China (81822017 and 32070955)。
文摘Stem cell transplantation holds a promising future for central nervous system repair. Current challenges, however, include spatially and temporally defined cell differentiation and maturation, plus the integration of transplanted neural cells into host circuits. Here we discuss the potential advantages of neuromodulation-based stem cell therapy, which can improve the viability and proliferation of stem cells, guide migration to the repair site,orchestrate the differentiation process, and promote the integration of neural circuitry for functional rehabilitation.All these advantages of neuromodulation make it one potentially valuable tool for further improving the efficiency of stem cell transplantation.
基金Supported by National Key Research and Development Program of China,No.2018YFC2002202.
文摘BACKGROUND Management of non-neurogenic,non-obstructive dysuria represents one of the most challenging dilemmas in urological practice.The main clinical symptom is the increase in residual urine.Voiding dysfunction is the main cause of dysuria or urinary retention,mainly due to the decrease in bladder contraction(the decrease in contraction amplitude or duration)or the increase in outflow tract resistance.Sacral neuromodulation(SNM)has been used for>10 years to treat many kinds of lower urinary tract dysfunction.It has become increasingly popular in China in recent years.Consequently,studies focusing on nonneurogenic,non-obstructive dysuria patients treated by SNM are highly desirable.AIM To assess the outcome of two-stage SNM in non-neurogenic,non-obstructive dysuria.METHODS Clinical data of 54 patients(26 men,28 women)with non-neurogenic,nonobstructive dysuria treated by SNM from January 2012 to December 2016 in ten medical centers in China were retrospectively analyzed.All patients received two or more conservative treatments.The voiding diary,urgency score,and quality of life score before operation,after implantation of tined lead in stage I(test period),and during short-term follow-up(latest follow-up)after implantation of the implanted pulse generator in stage II were compared to observe symptom improvements.RESULTS Among the 54 study patients,eight refused to implant an implanted pulse generator because of the unsatisfactory effect,and 46 chose to embed the implanted pulse generator at the end of stage I.The conversion rate of stage I to stage II was 85.2%.The average follow-up time was 18.6 mo.There were significant differences between baseline(before stage I)and the test period(after stage I)in residual urine,voiding frequency,average voiding amount,maximum voiding amount,nocturia,urgency score,and quality of life score.The residual urine and urgency score between the test period and the latest follow-up time(after stage II)were also significantly different.No significant differences were observed for other parameters.No wound infection,electrode breakage,or other irreversible adverse events occurred.CONCLUSION SNM is effective for patients with non-neurogenic,non-obstructive dysuria showing a poor response to traditional treatment.The duration of continuous stimulation may be positively correlated with the improvement of residual urine.
基金Supported by National Institute of Diabetes and Digestive and Kidney Disease Grant,No.R01 DK031369
文摘Fecal incontinence is a disabling symptom with medical and social implications,including fear,embarrassment,isolation and even depression.Most patients live in seclusion and have to plan their life around the symptom,with secondary impairment of their quality of life.Conservative management and biofeedback therapy are reported to benefit a good percentage of those affected.However,surgery must be considered in the nonresponder population.Recently,sacral nerve electrostimulation,lately named neuromodulation,has been reported to benefit patients with fecal incontinence in randomized controlled trials more than placebo stimulation and conservative management,by some unknown mechanism.Neuromodulation is a minimally invasive procedure with a low rate of adverse events and apparently favorable cost-efficacy profile.This review is intended to expand knowledge about this effective intervention among the non-surgically skilled community who deals with this disabled group of patients.
基金This work was supported by the Hungarian Brain Research Program 2(2017-1.2.1.-NKP-2017)(to BV),by the NKFI(OTKA NN128293)from the European Union and the State of Hungary,co-financed by the European Social Fund in the framework of TAMOP-4.2.4.A/2-11/1-2012-0001 National Excellence Program(to BV)by the UNKP-20-3-I-PTE-472 New National Excellence Program of the Ministry for Innovation and Technology(to GS).
文摘Vision altering diseases,such as glaucoma,diabetic retinopathy,age-related macular degeneration,myopia,retinal vascular disease,traumatic brain injuries and others cripple many lives and are projected to continue to cause anguish in the foreseeable future.Gap junctions serve as an emerging target for neuromodulation and possible regeneration as they directly connect healthy and/or diseased cells,thereby playing a crucial role in pathophysiology.Since they are permeable for macromolecules,able to cross the cellular barriers,they show duality in illness as a cause and as a therapeutic target.In this review,we take recent advancements in gap junction neuromodulation(pharmacological blockade,gene therapy,electrical and light stimulation)into account,to show the gap junction’s role in neuronal cell death and the possible routes of rescuing neuronal and glial cells in the retina succeeding illness or injury.
文摘Brain, an organ similar to a computer, is the ultimate director of the body1. This means that organs, tissues and cells are under its control and that these parts of the body do not control what happen to them. If the brain is functioning properly, we have health;and if it works wrongly a disease will show. Acting on the brain by neuromodulation, by means of acupuncture, homeopathy or even allopathic drugs can produce a therapeutic response. The purpose of this paper is to recognize this effect and propose a new Law of Cure which explains how several complementary and alternative medicine (CAM) systems work. In this theory, acupuncture works by stimulating peripheral sensory receptors and transmitting information to the brain which in turn will trigger a curative response to the affected organ. In this sense, acupuncture is an informatics system for a biological system, and therefore it could be considered part of the bioinformatics sciences, in the same idea that the brain is a living computer which has inputs and outputs and controls all process inside the body. In this paper we present the basis for this theory.
文摘Objective: To review the evidence surrounding Sacral Neuromodulation therapy and delineate areas that will need more research. Methods: An extensive search was performed on the available literature on SNM for lower urinary tract dysfunction. Based on the results of the search, the mechanisms of action, indications, technique, and patient characteristics of therapy failures and success are presented and discussed. Results: SNM is accepted by the FDA since 1997 for the treatment of lower urinary tract dysfunction. As it is a relatively new procedure, there are variations in the technique of lead placement, generator choice, testing interval, patient selection, time to explantation, and definitions of therapy failures and successes. Conclusions: SNM is a safe and therapeutic option for the treatment of urgencyfrequency syndrome, urge incontinence, and idiopathic urinary retention. However, there are multiple unanswered questions that require extensive research.
