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Neuromodulation : Journal of the... Jun 2024Transcranial direct current stimulation (tDCS) is used to modulate neuronal activity, but the exact mechanism of action (MOA) is unclear. This study investigates...
BACKGROUND
Transcranial direct current stimulation (tDCS) is used to modulate neuronal activity, but the exact mechanism of action (MOA) is unclear. This study investigates tDCS-induced modulation of the corticospinal excitability and the underlying MOA. By anesthetizing the scalp before applying tDCS and by stimulating the cheeks, we investigated whether stimulation of peripheral and/or cranial nerves contributes to the effects of tDCS on corticospinal excitability.
MATERIALS AND METHODS
In a randomized cross-over study, four experimental conditions with anodal direct current stimulation were compared in 19 healthy volunteers: 1) tDCS over the motor cortex (tDCS-MI), 2) tDCS over the motor cortex with a locally applied topical anesthetic (TA) on the scalp (tDCS-MI + TA), 3) DCS over the cheek region (DCS-C), and 4) sham tDCS over the motor cortex(sham). tDCS was applied for 20 minutes at 1 mA. Motor evoked potentials (MEPs) were measured before tDCS and immediately, 15, 30, 45, and 60 minutes after tDCS. A questionnaire was used to assess the tolerability of tDCS.
RESULTS
A significant MEP amplitude increase compared with baseline was found 30 minutes after tDCS-MI, an effect still observed 60 minutes later; no time∗condition interaction effect was detected. In the other three conditions (tDCS-MI + TA, DCS-C, sham), no significant MEP modulation was found. The questionnaire indicated that side effects are significantly lower when the local anesthetic was applied before stimulation than in the other three conditions.
CONCLUSIONS
The significant MEP amplitude increase observed from 30 minutes on after tDCS-MI supports the modulatory effect of tDCS on corticospinal neurotransmission. This effect lasted one hour after stimulation. The absence of a significant modulation when a local anesthetic was applied suggests that effects of tDCS are not solely established through direct cortical stimulation but that stimulation of peripheral and/or cranial nerves also might contribute to tDCS-induced modulation.
PubMed: 38878056
DOI: 10.1016/j.neurom.2024.05.002 -
Computers in Biology and Medicine Jun 2024Registering the head and estimating the scalp surface are important for various biomedical procedures, including those using neuronavigation to localize brain...
Registering the head and estimating the scalp surface are important for various biomedical procedures, including those using neuronavigation to localize brain stimulation or recording. However, neuronavigation systems rely on manually-identified fiducial head targets and often require a patient-specific MRI for accurate registration, limiting adoption. We propose a practical technique capable of inferring the scalp shape and use it to accurately register the subject's head. Our method does not require anatomical landmark annotation or an individual MRI scan, yet achieves accurate registration of the subject's head and estimation of its surface. The scalp shape is estimated from surface samples easily acquired using existing pointer tools, and registration exploits statistical head model priors. Our method allows for the acquisition of non-trivial shapes from a limited number of data points while leveraging their object class priors, surpassing the accuracy of common reconstruction and registration methods using the same tools. The proposed approach is evaluated in a virtual study with head MRI data from 1152 subjects, achieving an average reconstruction root-mean-square error of 2.95 mm, which outperforms a common neuronavigation technique by 2.70 mm. We also characterize the error under different conditions and provide guidelines for efficient sampling. Furthermore, we demonstrate and validate the proposed method on data from 50 subjects collected with conventional neuronavigation tools and setup, obtaining an average root-mean-square error of 2.89 mm; adding landmark-based registration improves this error to 2.63 mm. The simulation and experimental results support the proposed method's effectiveness with or without landmark annotation, highlighting its broad applicability.
PubMed: 38875907
DOI: 10.1016/j.compbiomed.2024.108689 -
Medicine Jun 2024To explore the clinical efficacy of scalp electroacupuncture combined with rehabilitation training for aphasia after head injury, and analyze its effect on patients'... (Observational Study)
Observational Study
Clinical efficacy of scalp electroacupuncture combined with rehabilitation training for aphasia after head injury and its effect on patients' language function and quality of life: An observational study.
To explore the clinical efficacy of scalp electroacupuncture combined with rehabilitation training for aphasia after head injury, and analyze its effect on patients' language function and quality of life. Our hospital randomly enrolled 100 aphasia patients caused by head injury treated from March 2020 to March 2022 as the experimental object and divided them into the control group and experimental group, with 50 cases in each group. The general rehabilitation training was performed to the control group and the scalp electroacupuncture combined with rehabilitation training was performed to the experimental group to compare their mini-mental state examination scores, communicative activities in daily living scores, aphasia battery of Chinese scores, quality of life scores, mental status scale in nonpsychiatric settings scores, National Institutes of Health Stroke Scale scores, effective rates, satisfaction of patients, and adverse reaction rates. In the between-group comparison, the patients in the experimental group had significantly higher mini-mental state examination scores, communicative activities in daily living scores, aphasia battery of Chinese scores, quality of life scores, effective rates, and satisfaction, and significantly lower mental status scale in nonpsychiatric settings scores, National Institutes of Health Stroke Scale scores and adverse reaction rates, which was statistically significant (P < .05 in all cases). The combination treatment of scalp electroacupuncture and rehabilitation training can effectively improve the language function and quality of life of patients with aphasia after head injury and remarkably enhance the treatment effect.
Topics: Humans; Quality of Life; Electroacupuncture; Female; Male; Middle Aged; Aphasia; Adult; Craniocerebral Trauma; Treatment Outcome; Scalp; Aged; Combined Modality Therapy; Language; Activities of Daily Living
PubMed: 38875369
DOI: 10.1097/MD.0000000000038263 -
The Oncologist Jun 2024Chemotherapy-induced alopecia is a common consequence of cancer treatment with a high psychological impact on patients and can be prevented by scalp cooling (SC). With...
BACKGROUND
Chemotherapy-induced alopecia is a common consequence of cancer treatment with a high psychological impact on patients and can be prevented by scalp cooling (SC). With this multi-center patient series, we examined the results for multiple currently used chemotherapy regimens to offer an audit into the real-world determinants of SC efficacy.
MATERIALS AND METHODS
The Dutch Scalp Cooling Registry collected data on 7424 scalp-cooled patients in 68 Dutch hospitals. Nurses and patients completed questionnaires on patient characteristics, chemotherapy, and SC protocol. Patient-reported primary outcomes at the start of the final SC session included head cover (HC) (eg, wig/scarf) use (yes/no) as a surrogate for patient satisfaction with SC and WHO score for alopecia (0 = no hair loss up to 3 = total alopecia) as a measure of scalp cooling success. Exhaustive logistic regression analysis stratified by chemotherapy regimen was implemented to examine characteristics and interactions associated with the SC result.
RESULTS
Overall, over half of patients (n = 4191, 56%) did not wear a HC and 53% (n = 3784/7183) reported minimal hair loss (WHO score 0/1) at the start of their final treatment. Outcomes were drug and dose dependent. Besides the chemotherapy regimen, this study did not identify any patient characteristic or lifestyle factor as a generic determinant influencing SC success. For non-gender specific cancers, gender played no statistically significant role in HC use nor WHO score.
CONCLUSIONS
Scalp cooling is effective for the majority of patients. The robust model for evaluating the drug and dose-specific determinants of SC efficacy revealed no indications for changes in daily practice, suggesting factors currently being overlooked. As no correlation was identified between the determinants explaining HC use and WHO score outcomes, new methods for evaluation are warranted.
PubMed: 38869252
DOI: 10.1093/oncolo/oyae116 -
Eplasty 2024
PubMed: 38863657
DOI: No ID Found -
Wounds : a Compendium of Clinical... May 2024Marjolin ulcer (MU) is an aggressive cutaneous malignancy that commonly occurs in those with a chronic wound such as post-burn scar. (Review)
Review
BACKGROUND
Marjolin ulcer (MU) is an aggressive cutaneous malignancy that commonly occurs in those with a chronic wound such as post-burn scar.
CASE REPORT
A 20-year-old male who sustained a flame burn over the scalp at 3 months of age developed a nonhealing ulcer over the burn scar 20 years later, which was treated with adequate surgical margins with adjuvant mold brachytherapy. Two months after completion of that treatment, he developed parotid nodal metastasis with positron emission tomography (PET)-positive bilateral cervical, supraclavicular, right suboccipital, and mesenteric lymph nodes that were treated with concurrent chemoradiation. One month later, the patient developed an ulcerative lesion involving the left parotid region with PET showing infiltration of the parotid gland, but with resolution of other previous sites of uptake. The patient was treated surgically with radical parotidectomy with elective neck dissection and reconstruction with locoregional flap. At 6-month follow-up, the patient developed extensive locoregional recurrence and distant metastasis and was started on oral metronomic therapy. The patient was alive with stable disease at 3-month follow-up after initiation of palliative chemotherapy.
CONCLUSION
Despite timely multimodality therapy, MU may present with a hostile clinical course with a short disease-free interval and early recurrence.
Topics: Humans; Male; Brachytherapy; Burns; Combined Modality Therapy; Neck Dissection; Neoplasm Recurrence, Local; Parotid Neoplasms; Plastic Surgery Procedures; Scalp; Skin Neoplasms; Skin Ulcer; Treatment Outcome; Adult
PubMed: 38861212
DOI: 10.25270/wnds/23138 -
SAGE Open Medical Case Reports 2024Perifolliculitis capitis abscedens et suffodiens, also known as dissecting cellulitis of the scalp, is a rare, chronic suppurative, inflammatory head hair follicle...
Perifolliculitis capitis abscedens et suffodiens, also known as dissecting cellulitis of the scalp, is a rare, chronic suppurative, inflammatory head hair follicle disease, which seriously affects the patient's quality of life. Clearly, clinical treatment varies widely and is somewhat challenging. We report a case of a 19-year-old male patient who had good results through surgery combined with photodynamic therapy. Surgery combined with photodynamic therapy for perifolliculitis capitis abscedens et suffodiens is effective and safe, especially for patients with poor responses to previous traditional treatments.
PubMed: 38859871
DOI: 10.1177/2050313X241260472 -
Plastic and Reconstructive Surgery.... Jun 2024Scalp reconstruction provides a unique challenge to the reconstructive surgeon, especially in terms of matching skin color and contour. We present a case of a...
Scalp reconstruction provides a unique challenge to the reconstructive surgeon, especially in terms of matching skin color and contour. We present a case of a 67-year-old man with a chronic scalp wound requiring soft tissue coverage after major debridement and coverage of a skull defect. We chose to use a super thin deep inferior epigastric perforator (DIEP) flap to provide good skin coverage along with good contour to the scalp. The use of a super thin DIEP flap, dissected above the superficial fascial plane, is a newer technique in the realm of free tissue transfers that has shown improved outcomes in wound contour. Although the DIEP flap has been popularized for breast reconstruction, the authors believe that it has the ability to provide good soft tissue and skin coverage to other areas of the body, including in head and neck reconstruction.
PubMed: 38855132
DOI: 10.1097/GOX.0000000000005891 -
Photodiagnosis and Photodynamic Therapy Jun 2024Actinic keratosis (AK) is a common precancerous condition found on sun-damaged skin. Tirbanibulin 1 % ointment has been approved for the topical treatment of...
Actinic keratosis (AK) is a common precancerous condition found on sun-damaged skin. Tirbanibulin 1 % ointment has been approved for the topical treatment of non-hyperkeratotic facial and scalp Olsen grade I AKs over a contiguous area of 25 cm with a daily application for 5 consecutive days. Our aim was to investigate the use of in vivo RCM in the assessment of the response of AKs treated with tirbanibulin, as it has never been described in the published Literature. A total of 10 AKs in 10 consecutive outpatients were enrolled in the present study in May 2023. The follow-up visit was scheduled after 30 days from last application of tirbanibulin ointment. At follow-up visit, a complete response was described by clinical, dermoscopic and in vivo RCM examination in 10 out of 10 lesions, with a recovery of stratum corneum, decrease in atypical honeycomb pattern and changes in dermal collagen. All patients were followed up for at least 8 months and further recurrences were not registered. Based on our experience, we confirm the efficacy and safety of tirbanibulin in treating AKs and the usefulness of RCM in vivo examination for the therapeutic monitoring of such lesions, even in a very early stage.
PubMed: 38851311
DOI: 10.1016/j.pdpdt.2024.104235 -
Parasitology Research Jun 2024This study aims to assess the effect of the COVID-19 pandemic on the consumption of self-care products for pediculosis capitis management, in Portugal. A segmented...
This study aims to assess the effect of the COVID-19 pandemic on the consumption of self-care products for pediculosis capitis management, in Portugal. A segmented regression analysis of interrupted time series (March 2020) was performed from January 2017 to August 2023 to analyze the short- and long-term impact of the COVID-19 pandemic on the consumption of pediculicides and related products. Monthly rates of absolute consumption were estimated by community pharmacies' dispensing records. Portuguese municipalities were organized into quintiles according to their purchasing power index and percentage of youth, to study the association of these social and demographic variables on the sale of these products. COVID-19 pandemic significantly reduced the sales of products indicated for pediculosis. Since the start of the pandemic, an absolute decrease of 21.0 thousand packages was observed in the monthly average consumption (p < 0.0001) compared to the pre-pandemic period. After this reduction, the average monthly trend increased in the pandemic period in comparison with the previous period, although not significant (267.0 packages per month, p = 0.1102). Regions with higher disposable income and more young people were associated with higher sales of these products. The outbreak of the COVID-19 pandemic has had a notable impact on the sales of self-care products for pediculosis capitis in Portugal, in the short term. The lockdowns and other isolation measures implemented to control the spread of the virus may have led to a decrease in the number of head lice cases, consequently resulting in a reduction in sales of products.
Topics: Portugal; Humans; COVID-19; Interrupted Time Series Analysis; Self Care; Lice Infestations; SARS-CoV-2; Animals; Scalp Dermatoses; Insecticides; Adolescent; Pandemics
PubMed: 38850458
DOI: 10.1007/s00436-024-08258-2