Vol 2-10 Mini Review

Blood-brain barrier derangement after electrical brain stimulation

Yumiko Watanabe1, N.A.R. Nik-Mohd-Afizan1,2, Ichiro Takashima1*

1Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology, 1-1-1 Umezono, Tsukuba 305-8568, Japan
2Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.

Noninvasive brain stimulation methods, including repetitive transcranial magnetic stimulation and transcranial direct current stimulation (tDCS), have received considerable attention in recent years for use in the study and treatment of neurological conditions. Of these methods, tDCS is considered particularly promising due to its ease of use and ability to confer polarity-dependent effects on brain excitability, making it an excellent option for clinical treatment of neurological and psychiatric diseases. While generally regarded as safe when following standard protocols, the effects of tDCS on cerebral blood vessels and blood-brain barrier (BBB) functions remain poorly understood. Here, we provide an overview of tDCS in the context of BBB function, summarize the current literature, and discuss implications for future research. To date, no alterations or damage to the BBB have been reported after weak tDCS stimulations in human subjects; however, some animal studies have reported alterations to BBB function following increased tDCS intensity, with inconsistencies in the effective tDCS polarity used to produce these BBB disruptions between studies. Further research will be necessary to evaluate the effects of tDCS on the BBB under various conditions. Finally, we discuss the potential of tDCS for enhancing drug delivery to the central nervous system, which may become possible as we refine our understanding of the effects of tDCS on BBB permeability.

DOI: 10.29245/2572.942X/2017/10.1162 View / Download Pdf View Full Text
Vol 2-10 Mini Review

A Review of Advances in Carpal Tunnel Release

Logan McCool1, Michel Kliot2, Danqing Guo3, Danzhu Guo3

1Department of Rehabilitation Medicine, University of Minnesota School of Medicine, Minneapolis MN 55455, USA
2Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA
3BayCare Clinic, Green Bay, WI 54303, USA

There have been many advances in recent years in peripheral nerve releases and most notably those involving median nerve entrapment at the wrist. This mini-review article focuses on the advances within the past five years in minimally, percutaneous, and ultra-minimally invasive techniques for carpal tunnel release. The progress in these surgical techniques has been made in part by the improvements in real time sonographic imaging. With each surgical technique, we look at the pre-clinical and clinical data and any complications from or limitations with these procedures. It is our aim with this article to spark discussion and spur innovation regarding ultrasound guided carpal tunnel release that can be applied to other peripheral nerve entrapments.

In the past five years, the surgical techniques to perform carpal tunnel release continue to advance. Among these surgical techniques is a growing trend towards less invasive methods and increased utilization of ultrasound guidance. In the literature, the list of methods includes open release, endoscopic release, minimally invasive release, percutaneous release, and ultra-minimally invasive release. These progressively less invasive techniques take advantage of the major improvements in both ultrasound image quality and real-time definition. This mini-review examines various surgical techniques involving minimally invasive, percutaneous, and ultra-minimally carpal tunnel release with emphasis on the development of techniques that are increasingly less invasive and more reliant on high-quality ultrasound imaging.

DOI: 10.29245/2572.942X/2017/10.1157 View / Download Pdf View Full Text