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Robert F. Dallapiazza, Kelsie F. Timbie, Stephen Holmberg, Jeremy Gatesman, M. Beatriz Lopes, Richard J. Price, G. Wilson Miller and W. Jeffrey Elias

renewed an interest in its use for neurosurgical applications. 3–6 , 18 , 19 , 28 Transcranial HIFU can be delivered in a precise, highly localized manner with millimeter accuracy to induce tissue ablation in deep cerebral structures in the human brain. The clinical effects of HIFU therapy have been highlighted in several recent clinical trials involving patients with movement disorders and psychiatric diseases. 2 , 9 , 11 , 20 , 25 , 26 Perhaps the most exciting, yet largely unharnessed, potential for transcranial ultrasound is for neuromodulation and noninvasive

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Zoe E. Teton, Daniel Blatt, Amr AlBakry, James Obayashi, Gulsah Ozturk, Vural Hamzaoglu, Philippe Magown, Nathan R. Selden, Kim J. Burchiel and Ahmed M. Raslan

L evel 1 evidence supports the use of neuromodulation technology for multiple indications: deep brain stimulation (DBS) for Parkinson’s disease (PD), 2 , 12 , 23 , 24 , 35 essential tremor (ET), 25 and dystonia; 34 vagus nerve stimulation (VNS) for refractory epilepsy; 17 , 21 , 33 and spinal cord stimulation (SCS) for chronic pain. 18 , 19 , 22 Neuromodulatory interventions may be difficult to sustain for some patients, in part because they depend on the ongoing function of implanted medical devices. The length of survival for various neuromodulatory

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Sarah K. B. Bick and Emad N. Eskandar

-compulsive disorder, 25 depression, 65 and Tourette syndrome. 42 In this review we assess the use of DBS and other forms of neuromodulation to alter signaling in core nodes of the memory circuitry with the aim of improving dysfunctional learning and memory. We first briefly review the neural circuitry of memory and its involvement in Alzheimer disease (AD) and TBI, and then evaluate the evidence for reducing memory deficits through neuromodulation. Introduction to Memory Anatomy of Memory Encoding and Retrieval The Papez circuit is part of the limbic circuitry and is

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Jan Kubanek

electric fields by using multiple sources. 7 , 20 However, a tightening of focus in a central region accompanies a deterioration in regions surrounding the ancillary sources. Thus, noninvasive and targeted stimulation of specific nuclei or pathways deep in the brain has remained elusive. Transcranial Focused Ultrasound Transcranial focused ultrasound (FUS) is a novel neuromodulation approach that combines noninvasiveness and sharp spatial focus. 12 , 41 As its basis, ultrasound comprises a pressure wave of frequencies above the audible range. As a propagating wave

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Gary Rajah, Hamidreza Saber, Rasanjeet Singh and Leonardo Rangel-Castilla

N eurostimulation has proven effective for many diseases, including Parkinson’s disease 11 and essential tremor, 23 and has shown promising results for newer targets, including chronic pain, obsessive-compulsive disorder, 19 refractory depression, 34 and, most recently, neurocognitive disorders. 12 , 37 As advances in neuromodulation continue, its promise grows in remedying various neurological ailments. At this time, deep brain stimulation (DBS) devices consist of surgically implanted leads passed, using the assistance of neuronavigation, through the

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Su-Youne Chang, Christopher J. Kimble, Inyong Kim, Seungleal B. Paek, Kenneth R. Kressin, Joshua B. Boesche, Sidney V. Whitlock, Diane R. Eaker, Aimen Kasasbeh, April E. Horne, Charles D. Blaha, Kevin E. Bennet and Kendall H. Lee

and identification of stimulation-induced neurochemical changes evoked by DBS, we have developed a wirelessly controlled electrical neurostimulator, the Mayo Investigational Neuromodulation Control System (MINCS), as a prototype for future development of a human closed-loop neurostimulation system. To synchronize stimulation with FSCV recordings, MINCS is connected to WINCS by an optical fiber. By interleaving intervals of stimulation with FSCV scans, stimulus artifacts in the recorded data are eliminated. While conventional stimulators and electrochemical

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Contemporary concepts of pain surgery

JNSPG 75th Anniversary Invited Review Article

Kim J. Burchiel and Ahmed M. Raslan

, neuropathic pain is typically derived from some type of injury to the peripheral or central nervous system. Cancer pain is related to the progression of a malignancy, with both tissue injury and damage to the nervous system, which can produce both nociceptive and neuropathic pains. The surgical treatment of pain falls roughly into two types: ablative, or more properly destructive procedures, and neuromodulation. These two approaches to pain surgery will be discussed in some detail. The surgical treatment of TN incorporates principles of both ablative and nonablative surgery

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Allen L. Ho, Anne-Mary N. Salib, Arjun V. Pendharkar, Eric S. Sussman, William J. Giardino and Casey H. Halpern

, variable effectiveness, and serious side effects. Indeed, up to 75% of treated alcoholics relapse within 3 years. 64 The nucleus accumbens (NAc) plays a central role in the mesolimbic reward pathway, and has been the most well-studied target for neuromodulatory therapies for AUD. 36 In this review, we will discuss the evidence and concepts supporting the role of the NAc in AUD, summarize the findings from published NAc DBS studies in animal models and humans, and consider the challenges and propose future directions for neuromodulation of the NAc for the treatment of

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Vinita Batra, Thanh Lam N. Tran, Jessica Caputo, Glenn F. Guerin, Nicholas E. Goeders and Jessica Wilden

every day, and, when they did occur, reductions were on the order of approximately 40%. If our acute findings were due to a DBS-induced increase in dopaminergic transmission in the AcbSh, then our inconsistent and moderate effect is likely a byproduct of our nonselective method of neuromodulation. Although Acb high-frequency DBS may activate midbrain dopaminergic projection terminals, it also activates local cholinergic and GABAergic interneurons, which serve to attenuate any enhanced terminal dopamine release. This is in contrast to selective optogenetic activation

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Shyamal C. Bir, Subhas Konar, Tanmoy Maiti, Anil Nanda and Bharat Guthikonda

N euromodulation with a spinal cord stimulator (SCS; dorsal column stimulator) was first implemented in 1967 by Clyde Norman Shealy for the treatment of intractable pain. The complications of SCSs were initially due to poor patient selection and the mechanical disadvantage of the device. 7 , 8 However, in the last 2 decades, outcomes of neuromodulation with the SCS have improved significantly due to technological advancements and better surgical techniques. In 1989, the FDA approved the use of SCSs for the management of chronic pain syndrome. 6 Spinal