• Title/Summary/Keyword: magnetic stimulation

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Understanding Neurogastroenterology From Neuroimaging Perspective: A Comprehensive Review of Functional and Structural Brain Imaging in Functional Gastrointestinal Disorders

  • Kano, Michiko;Dupont, Patrick;Aziz, Qasim;Fukudo, Shin
    • Journal of Neurogastroenterology and Motility
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    • v.24 no.4
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    • pp.512-527
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    • 2018
  • This review provides a comprehensive overview of brain imaging studies of the brain-gut interaction in functional gastrointestinal disorders (FGIDs). Functional neuroimaging studies during gut stimulation have shown enhanced brain responses in regions related to sensory processing of the homeostatic condition of the gut (homeostatic afferent) and responses to salience stimuli (salience network), as well as increased and decreased brain activity in the emotional response areas and reduced activation in areas associated with the top-down modulation of visceral afferent signals. Altered central regulation of the endocrine and autonomic nervous responses, the key mediators of the brain-gut axis, has been demonstrated. Studies using resting-state functional magnetic resonance imaging reported abnormal local and global connectivity in the areas related to pain processing and the default mode network (a physiological baseline of brain activity at rest associated with self-awareness and memory) in FGIDs. Structural imaging with brain morphometry and diffusion imaging demonstrated altered gray- and white-matter structures in areas that also showed changes in functional imaging studies, although this requires replication. Molecular imaging by magnetic resonance spectroscopy and positron emission tomography in FGIDs remains relatively sparse. Progress using analytical methods such as machine learning algorithms may shift neuroimaging studies from brain mapping to predicting clinical outcomes. Because several factors contribute to the pathophysiology of FGIDs and because its population is quite heterogeneous, a new model is needed in future studies to assess the importance of the factors and brain functions that are responsible for an optimal homeostatic state.

Non-invasive Brain Stimulation and its Legal Regulation - Devices using Techniques of TMS and tDCS - (비침습적 뇌자극기술과 법적 규제 - TMS와 tDCS기술을 이용한 기기를 중심으로 -)

  • Choi, Min-Young
    • The Korean Society of Law and Medicine
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    • v.21 no.2
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    • pp.209-244
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    • 2020
  • TMS and tDCS are non-invasive devices that treat the diseases of patients or individual users, and manage or improve their health by applying stimulation to a brain through magnetism and electricity. The effect and safety of these devices have proved to be valid in several diseases, but research in this area is still much going on. Despite increasing cases of their application, legislations directly regulating TMS and tDCS are hard to find. Legal regulation regarding TMS and tDCS in the United States, Germany and Japan reveals that while TMS has been approved as a medical device with a moderate risk, tDCS has not yet earned approval as a medical device. However, the recent FDA guidance, European MDR changes, recalls in the US, and relevant legal provisions of Germany and Japan, as well as recommendations from expert groups all show signs of tDCS growing closer to getting approved as a medical device. Of course, safety and efficacy of tDCS can still be regulated as a general product instead of as a medical device. Considering multiple potential impacts on a human brain, however, the need for independent regulation is urgent. South Korea also lacks legal provisions explicitly regulating TMS and tDCS, but they fall into the category of the grade 3 medical devices according to the notifications of the Korean Ministry of Food and Drug Safety. And safety and efficacy of TMS are to be evaluated in compliance with the US FDA guidance. But no specific guidelines exist for tDCS yet. Given that tDCS devices are used in some hospitals in reality, and also at home by individual buyers, such a regulatory gap must quickly be addressed. In a longer term, legal system needs to be in place capable of independently regulating non-invasive brain stimulating devices.

Fabrication and Test of a Cell Exciter Actuated by an Electromagnetic Force for the Chondrogenic Differentiation of Mesenchymal Stem Cells

  • Park, Sin-Wook;Sim, Woo-Young;Park, Sang-Hyug;Min, Byoung-Hyun;Park, So-Ra;Yang, Sang-Sik
    • KIEE International Transactions on Electrophysics and Applications
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    • v.4C no.4
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    • pp.176-180
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    • 2004
  • This paper presents the fabrication and test of a micro cell exciter actuated by an electromagnetic force for the study on the chondrogenic differentiation of rabbit mesenchymal stem cells (MSCs). The micro cell exciter is designed to apply compressive loading to the alginate gel mixed with the MSCs. The magnetic cell exciter consists of an actuator component and a cartridge-type chamber component. An actuator is composed of a permanent magnet, a core and a coil. The chamber has seven PMMA wells and a cell culture Petri dish. Two types of alginate gels were stimulated by the cell exciters for 10 minutes every 12 hours for 7 days. In order to determine the expression of these matrix components during differentiation, RT-PCR analysis was performed. Collagen type II was expressed in the MSCs subjected to the compressive stimulation.

Upper Motor Neuron Involvement in Motor Neuron Disease: Motor Evoked Potentials Study (운동 신경원 질환에서의 상부 운동 신경원 침범: 운동 유발 전위 연구)

  • Kim, Sung Hun;Park, Kyung-Seok;Kim, Joo-Yong;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.2 no.2
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    • pp.107-113
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    • 2000
  • Background & Objectives : Motor evoked potentials(MEPs) to magnetic trans cranial stimulation were performed to evaluate upper motor neuron involvement and relationship to lower motor neuron involvement in motor neuron disease patients. Method : MEPs were obtained in the 17 consecutive patients with motor neuron disease. These patients were divided into three group based on clinical evidence of upper and lower motor neuron involvement, bulbar symptom; amyotrophic lateral sclerosis(ALS), progressive muscular atrophy(PMA), progressive bulbar palsy(PBP). MEPs were recorded from abductor pollicis brevis and abductor hallucis muscles. Abnormal MEPs were defined by delayed central motor conduction time or absent MEP. Results : MEPs were abnormal in 64%(11/17) of patients; 100%(7/7) in ALS, 64%(4/7) in PMA, 0%(0/3) in PBP respectively. In 68 total recording muscles, 34 muscles had evidence of motor weakness and showed abnormal responses in 59%(20/34). Whereas 34 muscles with normal strength, only 3%(1/34) of muscles showed abnormal response. Conclusion : MEPs are well correlated with upper motor neuron signs in ALS and may detect masking upper motor neuron signs in PMA. The muscles with lower motor neuron sign(weakness) usually relate with abnormal MEPs reponses.

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Analysing of the recent trends on the constitution diagnosis and treatment device patents (체질진단 및 치료기기 최신 특허동향 분석)

  • Lee, Yu-Jung;Lee, Jeon;Kim, Jong-Yeol
    • Korean Journal of Oriental Medicine
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    • v.13 no.2 s.20
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    • pp.91-100
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    • 2007
  • In this paper, We tried to analyze the patent trend on constitution diagnosis and treatment related technologies. For this, constitution diagnosis and treatment related technologies divided into 16 sub-technology by the advisory committee. And we analyzed patents applied in Korea, Japan, U.S.A., China, and Europe. The 16 sub-technology consist of pulse analyzer, skin diagnosis, tongue analyzer, face and body detector, face analyzer, voice analyzer, intelligence ontology, meridian diagnosis, infrared thermography, electric stimulation, laser, high and low frequency, physical, magnetic, and ultrasound therapy. As a result we found that patents of constitution diagnosis and treatment in Korea has been growing steadily in both quality and quantity since 1980s. The number of patent the pulse analyzer and low frequency therapy are larger than others. But applied relevant international patents, marketability of the patent and Cites per Patent (CPP) index are shown to be very low. In conclusion, to occupy key original technologies of the Oriental medical device, we need to apply more patent of the whole related technology and international patents.

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The Effect of Action Observational Physical Training on Manual Dexterity in Stroke Patients (동작관찰훈련이 뇌졸중 환자의 손 조작능력에 미치는 영향)

  • Kim, Jong-Man;Yang, Byoung-Il;Lee, Moon-Kyu
    • Physical Therapy Korea
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    • v.17 no.2
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    • pp.17-24
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    • 2010
  • The aim of this study was to determine the effect of action observational physical training (AOPT) on manual dexterity and corticomotor facilitation in stroke patients. Ten hemiparetic patients participated in this study. Each subject was asked to participate the three conditions; base condition (Base), physical training (PT), AOPT. Participants were asked to observe the action in the video that a therapist moved the blocks during the AOPT conditions. Corticomotor facilitation was determined in three conditions by monitoring changes in the amplitude of motor-evoked potentials (MEPs) elicited in hand muscles by transcranial magnetic stimulation. MEP responses were measured from the first dorsal interosseous after participants attended to three conditions. For the manual dexterity, Box and Block test (BBT) was used. The results of present study were summarized as follows: MEPs amplitude significantly tended to be larger than PT and Base condition. The scores of BBT in the AOPT condition were also significantly larger than other conditions. In conclusion, this finding of present study indicates that physical training for observation of an action is beneficial for enhancing a dexterity of paretic arm in stroke patients.

An Improved Case Report of Interstitial Cystitis/Bladder Pain Syndrome Treated by Korean Medicine Treatment (한의 복합 치료로 호전된 간질성 방광염/방광통증증후군 1례 : 증례보고)

  • Hwang, Su-In;Yoon, Young-Jin;Park, Jang-Kyung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.1
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    • pp.82-92
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    • 2021
  • Objectives: The purpose of this study is to report the clinical effectiveness of Korean medicine treatment on interstitial cystitis. Methods: The patient diagnosed with Interstitial cystitis/Bladder pain syndrome (IC/BPS) was treated with Korean medicine treatment during 22 days of hospitalization. The patient received Korean medicine treatment including herbal medicine, acupuncture, pharmacopuncture, moxibustion, cupping and extracorporeal magnetic stimulation therapy. The effect of treatment on IC/BPS was evaluated through the Numeric Rating Scale (NRS), voiding diary, and Interstitial Cystitis Symptom Index/Problem Index (ICSI/ICPI). Results: After the treatment, the clinical symptoms of IC/BPS such as pelvic pain, pelvic pressure, frequent urination and urinary urgency were improved. Also, the patient had better scores in ICSI/ICPI. Conclusions: This case report proved that the Korean medicine treatment may be effective for improving clinical symptoms of IC/BPS. However, a large-scale clinical study is needed in the future to prove the effectiveness of Korean medicine treatment for IC/BPS.

Treatment of Cushing's disease with macroadenoma through transsphenoidal surgery (나비굴경유 수술을 통해 완치된 뇌하수체 거대선종에 동반된 쿠싱병 1예)

  • Lee, Sang Ah;Moon, Jae Cheol
    • Journal of Medicine and Life Science
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    • v.18 no.1
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    • pp.16-19
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    • 2021
  • Cushing's disease (CD) is a rare illness characterized by chronic hypercortisolism secondary to the overproduction of adrenocorticotropic hormone by a pituitary adenoma, which is associated with a high risk of developing serious complications, such as diabetes mellitus, cardiovascular disease, and emotional disorders. Endoscopic transsphenoidal surgery is performed for the treatment of CD, and was initially preferred over other types of treatments. However, the recurrence after pituitary surgery for CD is a common problem after an initial successful surgery. In microadenomas, the remission rates were higher than those of macroadenoma. This patient had a giant tumor that was greater than 4 cm in length on sella magnetic resonance imaging, and panhypopituitarism was detected using a combined pituitary stimulation test. After transsphenoidal surgery, the patient required temporary hormone replacement for a short period of time. After 1 year, he showed a normal cortisol response on the overnight dexamethasone suppression test and low morning cortisol levels. Therefore, we indicated that the patient was cured of giant macroadenoma with panhypopituitarism before surgery, and thus, reported this case.

Functional MRI of Visual Cortex: Correlation between Photic Stimulator Size and Cortex Activation (시각피질의 기능적 MR 연구: 광자극 크기와 피질 활성화와의 관계)

  • 김경숙;이호규;최충곤;서대철
    • Investigative Magnetic Resonance Imaging
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    • v.1 no.1
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    • pp.114-118
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    • 1997
  • Purpose: Functional MR imaging is the method of demonstrating changes in regional cerebral blood flow produced by sensory, motor, and any other tasks. Functional MR of visual cortex is performed as a patient stares a photic stimulation, so adaptable photic stimulation is necessary. The purpose of this study is to evaluate whether the size of photic stimulator can affect the degree of visual cortex activation. Materials and Methods: Functional MR imaging was performed in 5 volunteers with normal visual acuity. Photic stimulator was made by 39 light-emitting diodes on a plate, operating at 8Hz. The sizes of photic stimulator were full field, half field and focal central field. The MR imager was Siemens 1.5-T Magnetom Vision system, using standard head coil. Functional MRI utilized EPI sequence (TR/TE= 1.0/51. Omsec, matrix $No.=98{\times}128$, slice thickness=8mm) with 3sets of 6 imaging during stimulation and 6 imaging during rest, all 36 scannings were obtained. Activation images were obtained using postprocessing software(statistical analysis by Z-score), and these images were combined with T-1 weighted anatomical images. The activated signals were quantified by numbering the activated pixels, and activation a index was obtained by dividing the pixel number of each stimulator size with the sum of the pixel number of 3 study using 3 kinds of stimulators. The correlation between the activation index and the stimulator size was analysed. Results: Mean increase of signal intensities on the activation area using full field photic stimulator was about 9.6%. The activation index was greatest on full field, second on half field and smallest on focal central field in 4. The index of half field was greater than that of full field in 1. The ranges of activation index were full field 43-73%(mean 55%), half field 22-40 %(mean 32%), and focal central field 5-24%(mean 13%). Conclusion: The degree of visual cortex activation increases with the size of photic stimulator.

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Difference of working memory according to academic achievement with college students: functional Magnetic Resonance Imaging (대학생의 학업성취도에 따른 시각적 작동 기억 차이: 기능적 자기공명영상법)

  • Hong, Jae-Ran;Hwang, Jung-Ha;Kim, Eun-Jung
    • Journal of the Korean Society of Radiology
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    • v.6 no.3
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    • pp.173-182
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    • 2012
  • It was well known that working memory highly related with academic achievement. The aim of this study was to investigate the differences of brain activation which visually evoked working memory(encoding and retrieval) through functional Magnetic Resonance Imaging(fMRI) in Higher Academic Achievement Group(HAAG) and Lower Academic Achievement Group(LAAG) of college students. 20 assigned college students participated in fMRI studies. They underwent totally 210 seconds repeated paradigm. Stimulation paradigm composed with resting time and encoding and retrieval seeing the figures from the mirror with head coil. The brain activation maps and their quantification were analyzed by the statistical parametric mapping(SPM99) program from level of significance 95%. HAAG was more significantly higher than LAAG in bilateral prefrontal lobe(brodmann 46) associated with working memory, inferior parietal lobe associated with attention, and visual association area in encoding figures test. Right dosoprefrontal lobe(BA 44), right fusiform gyrus associated with decision of figure and, lingual gyrus were more activated in retrieval test with HAAG. On the other hand, LAAG was more significantly higher than HAAG in cingulate gyrus during encoding test. Thalamus, basal ganglia, cerebellum were more activated in retrieval test. Consequently, We could guess from these results HAAG more effectively executed than LAAG in visual working memory test.