Evidence-Based Umbrella Review of Non-Invasive Neuromodulation in Chronic Neuropathic Pain.

Background And Objective: Non-invasive neuromodulation techniques (NIN), such as transcranial Direct Current Stimulation (tDCS) and repetitive Transcranial Magnetic Stimulation (rTMS), have been extensively researched for their potential to alleviate pain by reversing neuroplastic changes associated with neuropathic pain (NP), a prevalent and complex condition. However, treating NP remains challenging due to the numerous variables involved, such as different techniques, dosages and aetiologies. It is necessary to provide insights for clinicians and public healthcare managers to support clinical decision-making.

Photobiomodulation therapy in diabetes: Benefits for pain relief, quality of life, and wound healing.

Globally, 537 million people suffer from diabetes mellitus (DM), a condition often associated with sensory disturbances, wound development, and chronic pain, which significantly affects the quality of life and imposes a substantial economic burden. This study evaluated the effects of photobiomodulation (PBM) therapy on nociceptive and sensory changes in diabetic patients to understand pain manifestations and explore PBM's molecular mechanisms on wound healing. Twenty patients with type 2 DM underwent clinical assessments, completed pain and quality of life questionnaires, and had their pain sensitivity evaluated using the quantitative sensory test (QST).

METHA-NeP: effectiveness and safety of methadone for neuropathic pain: a controlled randomized trial.

In this randomized, double-blind, parallel placebo-controlled clinical trial, we evaluated the efficacy of methadone as an add-on therapy for people with chronic neuropathic pain (NP). Eighty-six patients were randomly assigned to receive methadone or placebo for 8 weeks. The primary outcome was the proportion of participants achieving at least 30% pain relief from baseline using a 100-mm pain Visual Analogue Scale.

The Effects of Glibenclamide on Cognitive Performance, Quality of Life, and Emotional Aspects Among Patients With Aneurysmal Subarachnoid Hemorrhage: A Randomized Controlled Trial.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) is associated with a high incidence of long-term cognitive impairment, decreased quality of life (QoL), and psychiatric disorders. The effects of glibenclamide on such outcomes in the setting of aSAH are unknown.

Objective: To assess the impact of glibenclamide in patients with aSAH on cognitive performance, QoL, and emotional aspects.

Transsylvian transopercular peri-central core hemispherotomy for treating epilepsy: anatomy, surgical technique, and clinical outcome.

Objective: The objective of this study was to display the anatomical landmarks, surgical technique, and clinical outcome of transsylvian transopercular peri-central core hemispherotomy (TTPH) for treating refractory epilepsy.

Methods: From 2011 to 2023, 26 patients (12 with Rasmussen syndrome, 8 with hemimegalencephaly/cortical malformations, and 6 with hypoxic-ischemic encephalopathy; mean [range] age 11.3 years [16 months to 35 years]; 13 females; and 13 with right-side pathology) underwent TTPH.

Large acute epidural hematoma from head pin fixation fracture.

Regarding head immobilization practices in neurosurgery, secondary fixation fractures are rare, underscoring the importance of precise pin positioning and an adequate force in the three-point clamp to achieve adequate fixation. Attention should be given to factors such as changes in bone metabolism.

Posterior insula repetitive transcranial magnetic stimulation for chronic pain in patients with Parkinson disease - pain type matters: A double-blinded randomized sham-controlled trial.

Objectives: Altered somatosensory processing in the posterior insula may play a role in chronic pain development and contribute to Parkinson disease (PD)-related pain. Posterior-superior insula (PSI) repetitive transcranial magnetic stimulation (rTMS) has been demonstrated to have analgesic effects among patients with some chronic pain conditions. This study aimed at assessing the efficacy of PSI-rTMS for treating PD-related pain.

The Effects of Head Elevation on Intracranial Pressure, Cerebral Perfusion Pressure, and Cerebral Oxygenation Among Patients with Acute Brain Injury: A Systematic Review and Meta-Analysis.

Background: Head elevation is recommended as a tier zero measure to decrease high intracranial pressure (ICP) in neurocritical patients. However, its quantitative effects on cerebral perfusion pressure (CPP), jugular bulb oxygen saturation (SjvO), brain tissue partial pressure of oxygen (PbtO), and arteriovenous difference of oxygen (AVDO) are uncertain. Our objective was to evaluate the effects of head elevation on ICP, CPP, SjvO, PbtO, and AVDO among patients with acute brain injury.

Does deep TMS really works for smoking cessation? A prospective, double blind, randomized, sham controlled study.

Introduction: A substantial proportion of smokers wishing to quit do not stop smoking when using current therapies to aid cessation. Magnetic pulses to specific brain areas designated as transcranial magnetic stimulation may modulate brain activity and thereby change chemical dependencies. Deep transcranial magnetic stimulation (dTMS) with the H4 coil stimulates neuronal pathways in the lateral prefrontal cortex and insula bilaterally, areas involved in tobacco addiction.

Trans-Spinal Theta Burst Magnetic Stimulation in Parkinson's Disease and Gait Disorders.

Background: Gait disorders in patients with Parkinson's disease (PD) can become disabling with disease progression without effective treatment.

Objectives: To investigate the efficacy of intermittent θ burst trans-spinal magnetic stimulation (TsMS) in PD patients with gait and balance disorders.

Methods: This was a randomized, parallel, double-blind, controlled trial.

New perspectives on assessment and understanding of the patient with cranial bone defect: a morphometric and cerebral radiodensity assessment.

Background: Skull defects after decompressive craniectomy (DC) cause physiological changes in brain function and patients can have neurologic symptoms after the surgery. The objective of this study is to evaluate whether there are morphometric changes in the cortical surface and radiodensity of brain tissue in patients undergoing cranioplasty and whether those variables are correlated with neurological prognosis.

Methods: This is a prospective cohort with 30 patients who were submitted to cranioplasty and followed for 6 months.

Phenotypical characterization of exteroceptive sensation and pain symptoms on diabetic patients.

Backgroud: Diabetic neuropathy (DN) is one of the most common complications of diabetes, affecting about half of individuals with the disease. Among the various symptoms of DN, the development of chronic pain stands out and manifests as exacerbated responses to sensorial stimuli. The conventional clinical treatments used for general neuropathy and associated painful symptoms, still brings uncomplete and unsatisfactory pain relief.

Homocysteine serum levels in patients with ruptured and unruptured intracranial aneurysms: a case-control study.

Background: There is very few data regarding homocysteine's influence on the formation and rupture of intracranial aneurysms.

Objective: To compare homocysteine levels between patients with ruptured and unruptured intracranial aneurysms, and to evaluate possible influences of this molecule on vasospasm and functional outcomes.

Methods: This is a retrospective, case-control study.

Repercussions of the Emergency neurological life support on scientific literature: a bibliometric study.

Background:  In 2012, the Neurocritical Care Society launched a compilation of protocols regarding the core issues that should be addressed within the first hours of neurological emergencies - the (ENLS).

Objective:  We aim to evaluate this repercussion through a bibliometric analysis.

Methods:  We searched Scopus on October 2022 for articles mentioning ENLS.

Treatment of Idiopathic Normal Pressure Hydrocephalus with a Novel Programmable Valve: Prospective Evaluation of Costs, Efficacy, and Safety.

 Programmable valves provide an equal or superior neurological outcome when compared with fixed pressure ones, with fewer complications, in treating idiopathic normal pressure hydrocephalus (iNPH) patients. Long-term costs of these treatments have not been properly compared in literature. We sought to compare costs, efficacy, and safety of 1-year treatment of iNPH patients with programmable valve Sphera Pro and a fixed pressure valve.

Role of temporary arterial occlusion in subarachnoid hemorrhage outcomes: a prospective cohort study.

Purpose: Temporary arterial occlusion (TAO) is a widespread practice in the surgical treatment of intracranial aneurysms. This study aimed to investigate TAO's role during ruptured aneurysm clipping as an independent prognostic factor on short- and long-term outcomes.

Methods: This prospective cohort included 180 patients with ruptured intracranial aneurysms and an indication of microsurgical treatment.

Clinical assessment of upper limb impairments and functional capacity in Parkinson's disease: a systematic review.

Background:  Parkinson's disease (PD) may progressively reduce the upper limb's functionality. Currently, there is no standardized upper limb functional capacity assessment in PD in the rehabilitation field.

Objective:  To identify specific outcome measurements to assess upper limbs in PD and access functional capacity.

Long-term tonic spinal cord stimulation in advanced Parkinson's disease: No effect from stimulation under placebo-controlled evaluation.

•Chronic spinal cord stimulation effectiveness was evaluated in four PD patients.•Double blinded cross over evaluation was performed using subthreshold stimulation.•An open label evaluation with regular suprathreshold stimulation was also performed.

TCD assessment in fulminant hepatic failure: Improvements in cerebral autoregulation after liver transplantation.

Introduction And Objectives: Acute liver failure, also known as fulminant hepatic failure (FHF), includes a spectrum of clinical entities characterized by acute liver injury, severe hepatocellular dysfunction and hepatic encephalopathy. The objective of this study was to assess cerebral autoregulation (CA) in 25 patients (19 female) with FHF and to follow up with seventeen of these patients before and after liver transplantation.

Patients And Methods: The mean age was 33.

Machine Learning Algorithms to Predict Delayed Cerebral Ischemia After Subarachnoid Hemorrhage: A Systematic Review and Meta-analysis.

Delayed cerebral ischemia (DCI) is a common and severe complication after subarachnoid hemorrhage (SAH). Logistic regression (LR) is the primary method to predict DCI, but it has low accuracy. This study assessed whether other machine learning (ML) models can predict DCI after SAH more accurately than conventional LR.