Pub Date : 2020-09-11DOI: 10.5772/intechopen.91780
V. Cimino, C. Chisari, F. Patti
Spasticity and dystonia are two neurological conditions with a broad range of clinical manifestations that can emerge at any age. Although the spasticity and dystonia symptoms are caused by different pathophysiological mechanisms, both of them may cause functional impairment that contributes to a poor quality of life. Spasticity is characterised by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex. It mostly occurs in disorders of the central nervous system (CNS) affecting the upper motor neurons, such as multiple sclerosis, amyotrophic lateral sclerosis, cerebrovascular diseases, cerebral palsy, traumatic brain injury, stroke, and spinal cord injury. Therapeutic options may combine, in various proportions, physical therapy, occupational therapy, self-rehabilitation, the use of orthoses and assistive devices, drug treatment, orthopaedic surgery, and neurosurgery. Dystonia is defined as a syndrome of involuntary movement that manifests as excessive muscle contractions that frequently cause twisting and repetitive movements or abnormal postures. It is often intensified or exacerbated by physical activity, and symptoms may progress into adjacent muscles. Dystonia has many different manifestations and causes, and many different treatment options are available. These options include physical and occupational therapy, oral medications, intramuscular injection of botulinum toxins, and neurosurgical interventions.
{"title":"Spasticity and Dystonia: A Brief Review","authors":"V. Cimino, C. Chisari, F. Patti","doi":"10.5772/intechopen.91780","DOIUrl":"https://doi.org/10.5772/intechopen.91780","url":null,"abstract":"Spasticity and dystonia are two neurological conditions with a broad range of clinical manifestations that can emerge at any age. Although the spasticity and dystonia symptoms are caused by different pathophysiological mechanisms, both of them may cause functional impairment that contributes to a poor quality of life. Spasticity is characterised by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex. It mostly occurs in disorders of the central nervous system (CNS) affecting the upper motor neurons, such as multiple sclerosis, amyotrophic lateral sclerosis, cerebrovascular diseases, cerebral palsy, traumatic brain injury, stroke, and spinal cord injury. Therapeutic options may combine, in various proportions, physical therapy, occupational therapy, self-rehabilitation, the use of orthoses and assistive devices, drug treatment, orthopaedic surgery, and neurosurgery. Dystonia is defined as a syndrome of involuntary movement that manifests as excessive muscle contractions that frequently cause twisting and repetitive movements or abnormal postures. It is often intensified or exacerbated by physical activity, and symptoms may progress into adjacent muscles. Dystonia has many different manifestations and causes, and many different treatment options are available. These options include physical and occupational therapy, oral medications, intramuscular injection of botulinum toxins, and neurosurgical interventions.","PeriodicalId":115461,"journal":{"name":"Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115192791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-07DOI: 10.5772/intechopen.93008
S. Rayegani, M. Babaee, S. A. Raeissadat
Spasticity is a poorly recognized but common symptom, present in a wide range of neurological conditions. It can have a major impact on those affected, much of which is potentially preventable. This chapter provides an excellent paradigm to incorporate many of the key elements fundamental to the management of chronic conditions and it is of relevance to those who work in spasticity rehabilitation.
{"title":"Rehabilitation Medicine Management of Spasticity","authors":"S. Rayegani, M. Babaee, S. A. Raeissadat","doi":"10.5772/intechopen.93008","DOIUrl":"https://doi.org/10.5772/intechopen.93008","url":null,"abstract":"Spasticity is a poorly recognized but common symptom, present in a wide range of neurological conditions. It can have a major impact on those affected, much of which is potentially preventable. This chapter provides an excellent paradigm to incorporate many of the key elements fundamental to the management of chronic conditions and it is of relevance to those who work in spasticity rehabilitation.","PeriodicalId":115461,"journal":{"name":"Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114263530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-13DOI: 10.5772/intechopen.91756
D. Priya, P. Abhishek
The technique was emanated in early 1960s; nowadays, deep brain stimulation (DBS) has become a huge practice in treatment of various movement disorders along with some psychiatric disorders. The advancement of DBS in different neurodegenerative diseases and managing patients with refractory brain disorders are closely related to the developments in technology. This development in regard with the device advancement along with the safe coupling of DBS to high-resolution imaging can help us to shape our knowledge in brain-wide networks and circuits linked with clinical aspects. DBS is found to be useful in learning and memory. On the contrary, traditional epilepsy surgeries are more complicated and technologically DBS is easier and more feasible. There are mild adverse effects of this DBS treatment, but a number of studies have shown positive treatment outcome with movement disorders and many kinds of psychiatric disorders too.
{"title":"Deep Brain Stimulation Approach in Neurological Diseases","authors":"D. Priya, P. Abhishek","doi":"10.5772/intechopen.91756","DOIUrl":"https://doi.org/10.5772/intechopen.91756","url":null,"abstract":"The technique was emanated in early 1960s; nowadays, deep brain stimulation (DBS) has become a huge practice in treatment of various movement disorders along with some psychiatric disorders. The advancement of DBS in different neurodegenerative diseases and managing patients with refractory brain disorders are closely related to the developments in technology. This development in regard with the device advancement along with the safe coupling of DBS to high-resolution imaging can help us to shape our knowledge in brain-wide networks and circuits linked with clinical aspects. DBS is found to be useful in learning and memory. On the contrary, traditional epilepsy surgeries are more complicated and technologically DBS is easier and more feasible. There are mild adverse effects of this DBS treatment, but a number of studies have shown positive treatment outcome with movement disorders and many kinds of psychiatric disorders too.","PeriodicalId":115461,"journal":{"name":"Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132997826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-05DOI: 10.5772/intechopen.92287
Said M. Yaiesh, A. Al-Terki, Tariq F. Al-Shaiji
Urological applications of neuromodulation and neurostimulation are among the most evolving fields for these technologies. First approved for management of refractory urge incontinence, different modalities of neuromodulation and stimulation have been tested, applied and verified for a vast spectrum of voiding and pelvic floor dysfunction disorders. The modalities of delivering this treatment have also evolved in the last three decades, with a focus on sacral neuromodulation. The experimental and established “off-label” applications of neuromodulation have also encompassed chronic pelvic pain disorders, including chronic prostatitis and bladder pain syndrome, among others. In this chapter, we discuss all the hypothesized theories suggested on how this technology provides therapeutic potential for a number of chronic and debilitating urological conditions, the modes of delivery be it anterior, sacral, and posterior tibial to name a few, and the evolving and future applications.
{"title":"Neuromodulation in Urology: Current Trends and Future Applications","authors":"Said M. Yaiesh, A. Al-Terki, Tariq F. Al-Shaiji","doi":"10.5772/intechopen.92287","DOIUrl":"https://doi.org/10.5772/intechopen.92287","url":null,"abstract":"Urological applications of neuromodulation and neurostimulation are among the most evolving fields for these technologies. First approved for management of refractory urge incontinence, different modalities of neuromodulation and stimulation have been tested, applied and verified for a vast spectrum of voiding and pelvic floor dysfunction disorders. The modalities of delivering this treatment have also evolved in the last three decades, with a focus on sacral neuromodulation. The experimental and established “off-label” applications of neuromodulation have also encompassed chronic pelvic pain disorders, including chronic prostatitis and bladder pain syndrome, among others. In this chapter, we discuss all the hypothesized theories suggested on how this technology provides therapeutic potential for a number of chronic and debilitating urological conditions, the modes of delivery be it anterior, sacral, and posterior tibial to name a few, and the evolving and future applications.","PeriodicalId":115461,"journal":{"name":"Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122483885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-03DOI: 10.5772/intechopen.89805
T. Bocci, R. Ferrucci, A. Priori, Massimiliano Valeriani, F. Sartucci
Transcranial direct stimulation (tDCS) in the treatment of intractable or marginally tractable pain is experiencing an increasing diffusion in many fields worldwide. Recently, new modality of tDCS application has been proposed and applied, as cerebellar transcranial direct current stimulation (ctDCS). Indeed, the cerebellum has been proved to play a role in pain processing and to be involved in a wide number of integrative functions. In this chapter, we encompass the history of the technique, analysis of principles, a general description, including the meth-odological procedures of ctDCS; then, main clinical applications and their main effects in perceptive threshold of pain and other sensation, pain intensity, and laser evoked potentials (LEPs) changes.
{"title":"Cerebellar Transcranial Direct Current Stimulation (ctDCS) Effect in Perception and Modulation of Pain","authors":"T. Bocci, R. Ferrucci, A. Priori, Massimiliano Valeriani, F. Sartucci","doi":"10.5772/intechopen.89805","DOIUrl":"https://doi.org/10.5772/intechopen.89805","url":null,"abstract":"Transcranial direct stimulation (tDCS) in the treatment of intractable or marginally tractable pain is experiencing an increasing diffusion in many fields worldwide. Recently, new modality of tDCS application has been proposed and applied, as cerebellar transcranial direct current stimulation (ctDCS). Indeed, the cerebellum has been proved to play a role in pain processing and to be involved in a wide number of integrative functions. In this chapter, we encompass the history of the technique, analysis of principles, a general description, including the meth-odological procedures of ctDCS; then, main clinical applications and their main effects in perceptive threshold of pain and other sensation, pain intensity, and laser evoked potentials (LEPs) changes.","PeriodicalId":115461,"journal":{"name":"Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117075855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-12DOI: 10.5772/intechopen.90725
Sara Schatz
Our chapter contends that extended intranasal insulin administration can preserve pragmatic functioning even when there are temporal lobe and frontal lobe brain volume losses consistent with AD disease progression. CT scans of a patient receiving extended intranasal insulin 6 years after AD diagnosis are compared with his CT scans at the original MCI diagnosis. The results demonstrate that areas of the brain associated with pragmatic functioning were not as affected as expected in late-stage AD patients. This, along with linguistic evidence of preserved pragmatic competence, indicates the likely effectiveness of intranasal insulin treatment in enhancing neuronal activity in certain areas of the brain associated with pragmatic competence.
{"title":"Intranasal Insulin as Promising Therapy for Preserving Pragmatic Competence in MCI and AD","authors":"Sara Schatz","doi":"10.5772/intechopen.90725","DOIUrl":"https://doi.org/10.5772/intechopen.90725","url":null,"abstract":"Our chapter contends that extended intranasal insulin administration can preserve pragmatic functioning even when there are temporal lobe and frontal lobe brain volume losses consistent with AD disease progression. CT scans of a patient receiving extended intranasal insulin 6 years after AD diagnosis are compared with his CT scans at the original MCI diagnosis. The results demonstrate that areas of the brain associated with pragmatic functioning were not as affected as expected in late-stage AD patients. This, along with linguistic evidence of preserved pragmatic competence, indicates the likely effectiveness of intranasal insulin treatment in enhancing neuronal activity in certain areas of the brain associated with pragmatic competence.","PeriodicalId":115461,"journal":{"name":"Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124957140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-20DOI: 10.5772/intechopen.90044
M. B. Royo-Salvador, Marco V. Fiallos-Rivera, H. Salca
Despite the important achievements made with respect to our understanding of their clinical and image features, Chiari malformations are the result of etiopathogenetic mechanisms still sunk into mystery, while most of the efforts to dissipate it are isolated attempts that deal with rather late, secondary pathogenetic events, such as the reduction of the posterior fossa volume, the crowdedness of its contents or the disturbances of the cerebrospinal fluid flow at the level of the foramen magnum. Nevertheless, until new research will shed light onto many of these processes, the actual partial, fragmented knowledge can be structured in a much more reliable manner if one holds the theory of caudal traction as a guiding principle. We present a potential pathogenesis that could culminate into an abnormal axial tension throughout the spinal cord, as well as some image and therapeutic features found during our clinical practice, testifying in favor of this relentless caudal traction.
{"title":"Caudal Traction as a Pathogenetic Mechanism of Chiari Malformation Type I","authors":"M. B. Royo-Salvador, Marco V. Fiallos-Rivera, H. Salca","doi":"10.5772/intechopen.90044","DOIUrl":"https://doi.org/10.5772/intechopen.90044","url":null,"abstract":"Despite the important achievements made with respect to our understanding of their clinical and image features, Chiari malformations are the result of etiopathogenetic mechanisms still sunk into mystery, while most of the efforts to dissipate it are isolated attempts that deal with rather late, secondary pathogenetic events, such as the reduction of the posterior fossa volume, the crowdedness of its contents or the disturbances of the cerebrospinal fluid flow at the level of the foramen magnum. Nevertheless, until new research will shed light onto many of these processes, the actual partial, fragmented knowledge can be structured in a much more reliable manner if one holds the theory of caudal traction as a guiding principle. We present a potential pathogenesis that could culminate into an abnormal axial tension throughout the spinal cord, as well as some image and therapeutic features found during our clinical practice, testifying in favor of this relentless caudal traction.","PeriodicalId":115461,"journal":{"name":"Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128800513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-14DOI: 10.5772/INTECHOPEN.88430
V. Vuletić, V. Rački, D. Chudy, N. Bogdanovic
Deep brain stimulation (DBS) is a functional neuromodulatory technique that involves the use of a neurostimulator to deliver electrical impulses to the brain. It primarily alleviates the motor symptoms in neurodegenerative diseases; however, it has been found beneficial in a multitude of neurological and psychiatric diseases, such as dystonia, essential tremor, Tourette syndrome, intractable pain, epilepsy, treatment-resistant depression, and obsessive-compulsive disorder. Nonmotor symptoms, such as neurobehavioral disorders, autonomic dysfunction, sleep dysfunction, and somatosensory dysfunction, play an important role in neurodegenerative diseases and have a significant impact on the quality of life. The effects of deep brain stimulation on these symptoms are not yet apparent, although early results are promising and warrant future investigations. The main problem in interpretation is the lack of studies in this field, as most have methodological issues or small sample sizes, which limit the strength of the evidence. However, it is clear that DBS has a promising future in the treatment of neurodegenerative diseases in general and will have a vital role in personalized medicine as functional neuroimaging and our understanding of brain physiology improve.
{"title":"Deep Brain Stimulation in Non-motor Symptoms of Neurodegenerative Diseases","authors":"V. Vuletić, V. Rački, D. Chudy, N. Bogdanovic","doi":"10.5772/INTECHOPEN.88430","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.88430","url":null,"abstract":"Deep brain stimulation (DBS) is a functional neuromodulatory technique that involves the use of a neurostimulator to deliver electrical impulses to the brain. It primarily alleviates the motor symptoms in neurodegenerative diseases; however, it has been found beneficial in a multitude of neurological and psychiatric diseases, such as dystonia, essential tremor, Tourette syndrome, intractable pain, epilepsy, treatment-resistant depression, and obsessive-compulsive disorder. Nonmotor symptoms, such as neurobehavioral disorders, autonomic dysfunction, sleep dysfunction, and somatosensory dysfunction, play an important role in neurodegenerative diseases and have a significant impact on the quality of life. The effects of deep brain stimulation on these symptoms are not yet apparent, although early results are promising and warrant future investigations. The main problem in interpretation is the lack of studies in this field, as most have methodological issues or small sample sizes, which limit the strength of the evidence. However, it is clear that DBS has a promising future in the treatment of neurodegenerative diseases in general and will have a vital role in personalized medicine as functional neuroimaging and our understanding of brain physiology improve.","PeriodicalId":115461,"journal":{"name":"Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127568765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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