Neuromodulation treatment devices Clause Samples

Neuromodulation treatment devices. In chapter two I will introduce the utility of neurostimulation (TMS) as a method for measuring aberrant inhibition and excitation, however given that 30% of patients remain refractory to AEDs (▇▇▇▇ and ▇▇▇▇▇▇, 2000) and that surgery may not always be feasible, neurostimulation devices have also emerged as promising adjunct treatments. The brain can either be stimulated directly with deep brain stimulation or indirectly via TMS through the intact scalp or external or subcutaneous stimulation of peripheral cranial nerves (vagal nerve stimulation (VNS) and external trigeminal nerve stimulation (eTNS), described below). Neurostimulation has some advantages over resective surgery, primarily it is reversible with side effects offset by discontinuing treatment or altering stimulation parameters. Furthermore it is feasible that that multiple foci could be targeted by one treatment, (Al-Otaibi et al., 2011). Although surgery has good success rates in TLE, when seizure onset is in other areas surgical outcomes are inferior (▇▇▇▇▇▇▇▇▇ and ▇▇▇▇▇, 2013). Numerous targets have been proposed for neurostimulation including the centromedian thalamic nucleus and the anterior thalamus, although the only devices currently approved by the FDA are VNS and the Neuropace device RNS, although deep brain stimulation and eTNS are approved as treatments in Europe.