Cardiac sensing at a spinal cord stimulation lead: a promising on-device potential biomarker for pain and wellbeing.

In the search for objective measures of therapeutic outcomes for patients with spinal cord stimulation (SCS) devices, various metrics of cardiac performance have been linked to pain as well as overall health. To track such measures at home, recent studies have incorporated wearables to monitor cardiac activity over months or years. The drawbacks to wearables, such as patient compliance, would be obviated by on-device sensing that incorporates the SCS lead.

Visualizing the modulation of neurokinin 1 receptor-positive neurons in the superficial dorsal horn by spinal cord stimulation in vivo.

Spinal cord stimulation (SCS) is an effective modality for pain treatment, yet its underlying mechanisms remain elusive. Neurokinin 1 receptor-positive (NK1R+) neurons in spinal lamina I play a pivotal role in pain transmission. To enhance our mechanistic understanding of SCS-induced analgesia, we investigated how different SCS paradigms modulate the activation of NK1R+ neurons, by developing NK1R-Cre;GCaMP6s transgenic mice and using in vivo calcium imaging of superficial NK1R+ neurons under anesthesia (1.

Modulation of heart rate by temporally patterned vagus nerve stimulation in the anesthetized dog.

Despite current knowledge of the myriad physiological effects of vagus nerve stimulation (VNS) in various mammalian species (including humans), the impact of varying stimulation parameters on nerve recruitment and physiological responses is not well understood. We investigated nerve recruitment, cardiovascular responses, and skeletal muscle responses to different temporal patterns of VNS across 39 combinations of stimulation amplitude, frequency, and number of pulses per burst. Anesthetized dogs were implanted with stimulating and recording cuff electrodes around the cervical vagus nerve, whereas laryngeal electromyogram (EMG) and heart rate were recorded.

Microbiological effects of periodontal therapy plus azithromycin in patients with diabetes: results from a randomized clinical trial.

Current evidence suggests that periodontal infection may aggravate diabetes control. The aim of this study was to determine the changes in the frequency with which Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans were detected in patients with diabetes with the use of non-surgical therapy plus azithromycin in a randomized clinical trial. One hundred and five (105) patients with diabetes and chronic periodontitis were randomly assigned to three treatment groups: subgingival mechanical therapy with azithromycin, subgingival mechanical therapy with placebo and supragingival prophylaxis with azithromycin.

Selection of muscle and nerve-cuff electrodes for neuroprostheses using customizable musculoskeletal model.

Neuroprosthetic systems based on functional electrical stimulation aim to restore motor function to individuals with paralysis following spinal cord injury. Identifying the optimal electrode set for the neuroprosthesis is complicated because it depends on the characteristics of the individual (such as injury level), the force capacities of the muscles, the movements the system aims to restore, and the hardware limitations (number and type of electrodes available). An electrode-selection method has been developed that uses a customized musculoskeletal model.

Occurrence of red complex microorganisms and Aggregatibacter actinomycetemcomitans in patients with diabetes.

Aim: The aim of the present study was to analyze the occurrence of Porphyromonas gingivalis (P. gingivalis), Tannerella forsythia (T. forsythia), Treponema denticola (T.

High-resolution measurement of electrically-evoked vagus nerve activity in the anesthetized dog.

Objective: Not fully understanding the type of axons activated during vagus nerve stimulation (VNS) is one of several factors that limit the clinical efficacy of VNS therapies. The main goal of this study was to characterize the electrical recruitment of both myelinated and unmyelinated fibers within the cervical vagus nerve.

Approach: In anesthetized dogs, recording nerve cuff electrodes were implanted on the vagus nerve following surgical excision of the epineurium.

Selective control of physiological responses by temporally-patterned electrical stimulation of the canine vagus nerve.

Vagus nerve stimulation (VNS) is effective for treating epilepsy and depression, and has emerging indications for anxiety and heart failure. However, stimulation-evoked side effects remain a challenge for long-term compliance. We investigated the feasibility of reducing VNS side effects by using a temporally-modified stimulation pattern.

Tooth and periodontal clinical attachment loss are associated with hyperglycemia in patients with diabetes.

Background: Periodontal disease has been associated with diabetes, but there is still controversy on the relationship between periodontal clinical parameters and glycemic control. The purpose of this study is to assess the relationship between blood glucose levels and clinical parameters of periodontal disease in individuals with diabetes.

Methods: A total of 65 individuals with diabetes and 81 individuals without diabetes were included in the study.

Excitation properties of the right cervical vagus nerve in adult dogs.

Vagus nerve stimulation (VNS) is an approved treatment for epilepsy and depression, and it is currently under investigation for applications in Alzheimer's disease, anxiety, heart failure, and obesity. However, the mechanism(s) by which VNS has its effects are not clear, and the stimulation parameters for obtaining therapeutic outcomes appear highly variable. The purpose of this study was to quantify the excitation properties of the right cervical vagus nerve in adult dogs anesthetized with propofol and fentanyl.

Feasibility of EMG-based neural network controller for an upper extremity neuroprosthesis.

The overarching goal of this project is to provide shoulder and elbow function to individuals with C5/C6 spinal cord injury (SCI) using functional electrical stimulation (FES), increasing the functional outcomes currently provided by a hand neuroprosthesis. The specific goal of this study was to design a controller based on an artificial neural network (ANN) that extracts information from the activity of muscles that remain under voluntary control sufficient to predict appropriate stimulation levels for several paralyzed muscles in the upper extremity. The ANN was trained with activation data obtained from simulations using a musculoskeletal model of the arm that was modified to reflect C5 SCI and FES capabilities.

Musculoskeletal model-guided, customizable selection of shoulder and elbow muscles for a C5 SCI neuroprosthesis.

Individuals with C5/C6 spinal cord injury (SCI) have a number of paralyzed muscles in their upper extremities that can be electrically activated in a coordinated manner to restore function. The selection of a practical subset of paralyzed muscles for stimulation depends on the specific condition of the individual, the functions targeted for restoration, and surgical considerations. This paper presents a musculoskeletal model-based approach for optimizing the muscle set used for functional electrical stimulation (FES) of the shoulder and elbow in this population.

A musculoskeletal model of the upper extremity for use in the development of neuroprosthetic systems.

Upper extremity neuroprostheses use functional electrical stimulation (FES) to restore arm motor function to individuals with cervical level spinal cord injury. For the design and testing of these systems, a biomechanical model of the shoulder and elbow has been developed, to be used as a substitute for the human arm. It can be used to design and evaluate specific implementations of FES systems, as well as FES controllers.

EMG-based control for a C5/C6 spinal cord injury upper extremity neuroprosthesis.

The goal of this project is to enhance the benefits of functional electrical stimulation (FES) for individuals with cervical mid-level spinal cord injury (C5-C6 SCI) by providing upper arm function that complements the hand function provided by current FES systems. As a result of stimulation to selected shoulder and elbow muscles, individuals are able to increase their range of motion, their reaching ability, and improve their overall shoulder stability. An approach that provides a natural way of controlling arm stimulation is proposed.

Adaptive neural network controller for an upper extremity neuroprosthesis.

The long term goal of this project is to develop an adaptive neural network controller for an upper extremity neuroprosthesis targeted for people with C5/C6 spinal cord injury (SCI). The challenge is to determine how to simultaneously stimulate different paralyzed muscles based on the EMG activity of muscles under retained voluntary control. The controller extracts the movement intention from the recorded EMG signals and generates the appropriate stimulation levels to activate the paralyzed muscles.