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Zhu X, Shen Q. Effect of Low-Frequency Pulsed Electrotherapy Combined with Acupoint Nursing on Postpartum Urinary Retention in Patients with Vaginal Delivery. Int Urogynecol J 2024; 35:1227-1234. [PMID: 38733382 DOI: 10.1007/s00192-024-05804-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/08/2024] [Indexed: 05/13/2024]
Abstract
INTRODUCTION AND HYPOTHESIS This study was carried out to investigate the effect of low-frequency pulsed electrotherapy combined with acupoint massage on postpartum urinary retention (PUR). METHODS The patients were divided into control group, intervention group 1, and intervention group 2 according to the nursing method. The control group received conventional postpartum care, intervention group 1 received conventional postpartum care and low frequency pulsed electrotherapy, and intervention group 2 received conventional postpartum care, low-frequency pulsed electrotherapy, and Shuidao point massage. The bladder function, comfort score, and quality of life score before and after intervention were compared among the three groups. RESULTS The bladder function, comfort level, and quality of life of intervention group 1 and intervention group 2 after nursing were significantly better than those of the control group. In addition, intervention group 2 had better bladder function than intervention group 1, with lower residual urine volume and higher bladder compliance. In the Kolcaba score, the mental dimension of intervention group 2 was significantly higher than that of intervention group 1. In terms of QOL scores, the social function, physical function, and state of material life scores of intervention group 2 were significantly higher than those of intervention group 1. CONCLUSIONS Low-frequency pulsed electrotherapy combined with acupoint massage can significantly improve the bladder function, comfort, and quality of life of patients with PUR.
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Affiliation(s)
- Xinhui Zhu
- Obstetrics Department, The First Affiliated Hospital of Soochow University, No. 188, Shizi Street, Suzhou, 215000, Jiangsu, China
| | - Qian Shen
- Obstetrics Department, The First Affiliated Hospital of Soochow University, No. 188, Shizi Street, Suzhou, 215000, Jiangsu, China.
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Song LJ, Zhang H, Qu XP, Jin JG, Wang C, Jiang X, Gao L, Li G, Wang DL, Shen LL, Liu B. Increased expression of Rho-associated protein kinase 2 confers astroglial Stat3 pathway activation during epileptogenesis. Neurosci Res 2021; 177:25-37. [PMID: 34740726 DOI: 10.1016/j.neures.2021.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/28/2021] [Accepted: 10/31/2021] [Indexed: 10/19/2022]
Abstract
Patients with TLE are prone to tolerance to antiepileptic drugs. Based on the perspective of molecular targets for drug resistance, it is necessary to explore effective drug resistant genes and signaling pathways for the treatment of TLE. We performed gene expression profiles in hippocampus of patients with drug-resistant TLE and identified ROCK2 as one of the 20 most significantly increased genes in hippocampus. In vitro and in vivo experiments were performed to identify the potential role of ROCK2 in epileptogenesis. In addition, the activity of Stat3 pathway was tested in rat hippocampal tissues and primary cultured astrocytes. The expression levels of ROCK2 in the hippocampus of TLE patients were significantly increased compared with the control group, which was due to the hypomethylation of ROCK2 promoter. Fasudil, a specific Rho-kinase inhibitor, alleviated epileptic seizures in the pilocarpine rat model of TLE. Furthermore, ROCK2 activated the Stat3 pathway in pilocarpine-treated epilepsy rats, and the spearman correlation method confirmed that ROCK2 is associated with Stat3 activation in TLE patients. In addition, ROCK2 was predominantly expressed in astrocytes during epileptogenesis, and induced epileptogenesis by activating astrocyte cell cycle progression via Stat3 pathway. The overexpressed ROCK2 plays an important role in the pathogenesis of drug-resistant epilepsy. ROCK2 accelerates astrocytes cell cycle progression via the activation of Stat3 pathway likely provides the key to explaining the process of epileptogenesis.
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Affiliation(s)
- Li-Jia Song
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Hua Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiao-Peng Qu
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Jun-Gong Jin
- Department of Neurosurgery, Xi'an International Medical Center, Xi'an, China
| | - Chao Wang
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Xue Jiang
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Li Gao
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Gang Li
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Da-Li Wang
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Liang-Liang Shen
- Department of Biochemistry and Molecular Biology, Fourth Military Medical University, Xi'an, China.
| | - Bei Liu
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
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Leiphart JW, Ye Z, Lee M, Loew MH. Threshold for Tonic Motor Effects from Random Waveform in a Rat Experimental Model of Frontal Cortex Stimulation. Stereotact Funct Neurosurg 2020; 97:313-318. [PMID: 31910428 DOI: 10.1159/000503022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 08/27/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Brain stimulation is utilized to treat a variety of neurological disorders. Clinical brain stimulation technologies currently utilize charge-balanced pulse stimulation. The brain may better respond to other stimulation waveforms. This study was designed to evaluate the motor threshold of the brain to stimulation with various waveforms. METHODS Three stimulation waveforms were utilized on rats with surgically implanted brain electrodes: pulses, square waves, and random waveform. The peak-to-peak stimulation voltage was increased in a step-wise manner until motor signs were elicited. RESULTS The random waveform had the highest motor threshold with brain stimulation compared to the other waveforms. Random waveform stimulation reached maximum voltage without motor side effects while stimulating through both 1 and 8 electrodes. In contrast, the stimulation thresholds for motor side effects of the other two waveforms were on average less than half of the maximum voltage and lower for stimulation through 8 electrodes than stimulation through 1 electrode (p < 0.0005). CONCLUSION The random waveform was better tolerated than the other waveforms and may allow for the use of higher stimulation voltage without side effects.
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Affiliation(s)
- James W Leiphart
- Department of Neurosciences, Inova Health System, Falls Church, Virginia, USA, .,Virginia Commonwealth University, Richmond, Virginia, USA,
| | - Zhixing Ye
- Department of Electrical and Computer Engineering, George Washington University, Washington, District of Columbia, USA
| | - Michaela Lee
- Health Sciences Department of Neurological Surgery, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Murray H Loew
- Department of Biomedical Engineering, George Washington University, Washington, District of Columbia, USA
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Vuong J, Devergnas A. The role of the basal ganglia in the control of seizure. J Neural Transm (Vienna) 2017; 125:531-545. [PMID: 28766041 DOI: 10.1007/s00702-017-1768-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 07/23/2017] [Indexed: 12/19/2022]
Abstract
Epilepsy is a network disorder and each type of seizure involves distinct cortical and subcortical network, differently implicated in the control and propagation of the ictal activity. The role of the basal ganglia has been revealed in several cases of focal and generalized seizures. Here, we review the data that show the implication of the basal ganglia in absence, temporal lobe, and neocortical seizures in animal models (rodent, cat, and non-human primate) and in human. Based on these results and the advancement of deep brain stimulation for Parkinson's disease, basal ganglia neuromodulation has been tested with some success that can be equally seen as promising or disappointing. The effect of deep brain stimulation can be considered promising with a 76% in seizure reduction in temporal lobe epilepsy patients, but also disappointing, since only few patients have become seizure free and the antiepileptic effects have been highly variable among patients. This variability could probably be explained by the heterogeneity among the patients included in these clinical studies. To illustrate the importance of specific network identification, electrophysiological activity of the putamen and caudate nucleus has been recorded during penicillin-induced pre-frontal and motor seizures in one monkey. While an increase of the firing rate was found in putamen and caudate nucleus during pre-frontal seizures, only the activity of the putamen cells was increased during motor seizures. These preliminary results demonstrate the implication of the basal ganglia in two types of neocortical seizures and the necessity of studying the network to identify the important nodes implicated in the propagation and control of each type of seizure.
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Affiliation(s)
- J Vuong
- Yerkes National Primate Research Center, Emory University, 954 Gatewood Road NE, Atlanta, GA, 30329, USA
| | - Annaelle Devergnas
- Yerkes National Primate Research Center, Emory University, 954 Gatewood Road NE, Atlanta, GA, 30329, USA. .,Department of Neurology, Emory University, Atlanta, GA, 30322, USA.
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BUFFEL INE, MEURS ALFRED, RAEDT ROBRECHT, DE HERDT VEERLE, DECORTE LEEN, BERTIER LAURENCE, DELBEKE JEAN, WADMAN WYTSE, VONCK KRISTL, BOON PAUL. THE EFFECT OF HIGH AND LOW FREQUENCY CORTICAL STIMULATION WITH A FIXED OR A POISSON DISTRIBUTED INTERPULSE INTERVAL ON CORTICAL EXCITABILITY IN RATS. Int J Neural Syst 2014; 24:1430005. [DOI: 10.1142/s0129065714300058] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Neurostimulation is a promising treatment for refractory epilepsy. We studied the effect of cortical stimulation with different parameters in the rat motor cortex stimulation model. High intensity simulation (threshold for motor response - 100 μA), high frequency (130 Hz) stimulation during 1 h decreased cortical excitability, irrespective of the interpulse interval used (fixed or Poisson distributed). Low intensity (10 μA) and/or low frequency (5 Hz) stimulation had no effect. Cortical stimulation appears promising for the treatment of neocortical epilepsy if frequency and intensity are high enough.
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Affiliation(s)
- INE BUFFEL
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - ALFRED MEURS
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - ROBRECHT RAEDT
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - VEERLE DE HERDT
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - LEEN DECORTE
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - LAURENCE BERTIER
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - JEAN DELBEKE
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - WYTSE WADMAN
- Swammerdam Institute of Life Sciences, Department of Neurobiology, University of Amsterdam, Sciencepark 904, 1090 Amsterdam, The Netherlands
| | - KRISTL VONCK
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - PAUL BOON
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Department of Neurology, Ghent University, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
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Guo H, Zhang H, Kuang Y, Wang C, Jing X, Gu J, Gao G. Electrical Stimulation of the Substantia Nigra Pars Reticulata (SNr) Suppresses Chemically Induced Neocortical Seizures in Rats. J Mol Neurosci 2014; 53:546-52. [DOI: 10.1007/s12031-013-0220-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 12/19/2013] [Indexed: 11/29/2022]
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Responsive electrical stimulation suppresses epileptic seizures in rats. PLoS One 2012; 7:e38141. [PMID: 22662277 PMCID: PMC3360655 DOI: 10.1371/journal.pone.0038141] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 05/02/2012] [Indexed: 02/03/2023] Open
Abstract
Background A responsive electrical stimulation pattern based on our recently developed novel seizure prediction method was designed to suppress the penicillin-induced epileptic seizures. Methodology Seizures were induced by Penicillin injection at rat cortex. A responsive electrical stimulation system was triggered prior to seizures predicted with phase synchronisation. Rats with induced seizures were stimulated by the electrical pulses at a responsive or 1 Hz periodic pattern of an open system. The effectiveness of stimulation on seizures suppression was assessed by measuring the average number and duration of seizures per hour. Results The prediction algorithm reliably identified seizures in real time and triggered the responsive stimulation. This type of electrical stimulation dramatically suppressed seizure activity and the performance was better than the open stimulation system with fewer and shorter seizures. Conclusions A responsive electrical stimulation system triggered by the phase synchronisation prediction is able to significantly suppress seizures. Significance Responsive electrical stimulation could achieve superior treatment performance and reduce power consumption and side effects.
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Wang C, Wu H, He F, Jing X, Liang Q, Heng G, Wang L, Gao G, Zhang H. Alleviation of Ferric Chloride-Induced Seizures and Retarded Behaviour in Epileptic Rats by Cortical Electrical Stimulation Treatment. J Int Med Res 2012; 40:266-81. [PMID: 22429366 DOI: 10.1177/147323001204000127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE: To study the effects of low-frequency cortical electrical stimulation (CES) on seizures and behaviour in a rat model of epilepsy induced by ferric chloride (FeCl3). METHODS: Rats were randomly assigned into four groups ( n = 8 per group): normal healthy rats; saline-treated control rats; FeCl3-induced epileptic rats; CES-treated FeCl3-induced epileptic rats. Behavioural tests, analysis of the levels of brain-derived neurotrophic factor (BDNF) protein in brain tissue, and ultrastructural studies using transmission electron microscopy (TEM) were undertaken. RESULTS: CES significantly decreased the number and grade of seizures, and improved rat behaviour, compared with untreated epileptic rats. CES reduced levels of BDNF protein in the forebrain and increased levels of BDNF protein in the hippocampus compared with untreated epileptic rats. TEM showed less damage and ultrastructural changes in the neurons of CES-treated epileptic rats. CONCLUSIONS: CES inhibited seizures in FeCl3-induced epileptic rats and improved their behaviour. These effects might be mediated by altering BDNF protein levels in the brain.
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Affiliation(s)
- C Wang
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, ShanXi, Xi'an, China
| | - H Wu
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, ShanXi, Xi'an, China
| | - F He
- Department of Ophthalmology, Tangdu Hospital, Fourth Military Medical University, ShanXi, Xi'an, China
| | - X Jing
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, ShanXi, Xi'an, China
| | - Q Liang
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, ShanXi, Xi'an, China
| | - G Heng
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, ShanXi, Xi'an, China
| | - L Wang
- Department of Biomedical Engineering, Fourth Military Medical University, ShanXi, Xi'an, China
| | - G Gao
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, ShanXi, Xi'an, China
| | - H Zhang
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, ShanXi, Xi'an, China
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Vonck K, de Herdt V, Sprengers M, Ben-Menachem E. Neurostimulation for epilepsy. HANDBOOK OF CLINICAL NEUROLOGY 2012; 108:955-970. [PMID: 22939078 DOI: 10.1016/b978-0-444-52899-5.00040-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Kristl Vonck
- Department of Neurology, Ghent University Hospital, Ghent, Belgium.
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Blauwblomme T, Piallat B, Fourcade A, David O, Chabardès S. Cortical stimulation of the epileptogenic zone for the treatment of focal motor seizures: an experimental study in the nonhuman primate. Neurosurgery 2011; 68:482-90; discussion 490. [PMID: 21135746 DOI: 10.1227/neu.0b013e3181ff9d14] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cortical stimulation is under investigation in clinical trials of drug-resistant epilepsy. Results are heterogeneous; therefore, more evidence from animal studies is required. OBJECTIVE To investigate the therapeutic effects of parameters of direct stimulation of the cortical focus in a Macaca fascicularis presenting focal motor epilepsy. METHODS We developed a model of motor seizures after intracortical injection of penicillin G in the primary motor cortex of a Macaca fascicularis. We performed electric epidural cortical stimulation at low, medium, and high frequency using continuous or short-term stimulation. Short-term stimulation was triggered on seizure onset, either visually or automatically with a seizure detection algorithm connected to a programmable stimulator. RESULTS Automated detection could detect 100% of the seizures, but ensuing cortical electric stimulation failed to abort seizures. CONCLUSION This study demonstrates the inefficacy of the stimulation of the cortical focus to prevent seizures induced by local injection of penicillin G. Because this model may be too severe to allow comparison to human epilepsies, further work is required in other monkey models of focal epilepsy.
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Toward rational design of electrical stimulation strategies for epilepsy control. Epilepsy Behav 2010; 17:6-22. [PMID: 19926525 PMCID: PMC2818293 DOI: 10.1016/j.yebeh.2009.10.017] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Accepted: 10/12/2009] [Indexed: 11/21/2022]
Abstract
Electrical stimulation is emerging as a viable alternative for patients with epilepsy whose seizures are not alleviated by drugs or surgery. Its attractions are temporal and spatial specificity of action, flexibility of waveform parameters and timing, and the perception that its effects are reversible unlike resective surgery. However, despite significant advances in our understanding of mechanisms of neural electrical stimulation, clinical electrotherapy for seizures relies heavily on empirical tuning of parameters and protocols. We highlight concurrent treatment goals with potentially conflicting design constraints that must be resolved when formulating rational strategies for epilepsy electrotherapy, namely, seizure reduction versus cognitive impairment, stimulation efficacy versus tissue safety, and mechanistic insight versus clinical pragmatism. First, treatment markers, objectives, and metrics relevant to electrical stimulation for epilepsy are discussed from a clinical perspective. Then the experimental perspective is presented, with the biophysical mechanisms and modalities of open-loop electrical stimulation, and the potential benefits of closed-loop control for epilepsy.
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