Neuromodulatory Control Of Spinal Function In Health And Disease

The brainstem is a conduit connecting higher brain centers, cerebellum and spinal cord and provides the main sensory and motor innervation to the face, head and neck via the cranial nerves. It plays a pivotal role in the regulation of respiration, locomotion, posture, balance, arousal (alertness, awareness and consciousness), sensory information processing (nociception, etc.), autonomic functions (including control of bowel, bladder, blood pressure and heart rate) and is responsible for the regulation of numerous reflexes including swallowing, coughing and vomiting. It is controlled by higher brain centers originating from cortical and subcortical regions including the basal ganglia and diencephalon as well as feedback loops from the cerebellum and spinal cord. A modulatory control of brainstem output can be accomplished by affecting individual neurons and consequently, the operation of neural microcircuits and behavior. This is achieved by altering cellular excitability, synaptic transmission (release probability, postsynaptic receptor responsiveness, thus altering synaptic strength and efficacy) and network properties. Such dynamic control provides flexibility of the nervous system to adapt neural output according to the functional requirements and/or demands of the individual to achieve the desired behavioral state in a changing environment. Neuromodulation can be achieved by the "classical" neurotransmitters glutamate and GABA (gamma-amino butyric acid) by primary excitation and inhibition of the "anatomical network", but can also be achieved through the use of transmitters acting on G- protein coupled receptors. Such neuromodulators include the monoamines (serotonin, noradrenaline and dopamine), acetylcholine, but also glutamate and GABA. In addition, neuropeptides and purines act as neuromodulators. Other chemical mediators such as nitric oxide and growth factors may also have similar actions. The aim of this Research Topic is to highlight recent advances in our understanding of the intrinsic and extrinsic neuromodulatory systems affecting brainstem function from the anatomical, physiological and pharmacological perspective and to emphasize how these advances strengthen, modify or challenge existing conceptual models of sensorimotor and autonomic control.

Offers expert guidance on functional neurosurgery and neuromodulation, lists of requirements, and the instruments needed to perform these procedures. Answers practical questions such as "What do I need when performing a thermal procedure?", "What do I need to bear in mind when assembling a device?", and "What do I need to remember with regards to voltages, electrodes, percutaneous leads, RF generators, imaging, and micro instruments?" Consolidates today’s available information and guidance in this timely area into one convenient resource. Functional Neurosurgery and Neuromodulation provides comprehensive coverage of this emerging, minimally invasive area of health care. Recent advances in these areas have proven effective for pain relief, memory loss, addiction, and much more. This practical resource by Drs. Kim J. Burchiel and Ahmed Raslan brings you up to date with what’s new in the field and how it can benefit your patients.

Neuromodulation will be the first comprehensive and in-depth reference textbook covering all aspects of the rapidly growing field of neuromodulation. This book provides a complete discussion of the fundamental principles of neuromodulation and therapies applied to the brain, spinal cord, peripheral nerves, autonomic nerves and various organs. The textbook is highly structured and organized into overarching sections that cover chronic pain, movement disorders, psychiatric disorders, epilepsy, functional electrical stimulation, cardiac, gastrointestinal, genitourinary and organ neuromodulation. The fundamental principles of electricity and infusion, neural tissue interface, biomedical engineering, neuromodulation devices, basic science, neuroanatomy, neurophysiology, imaging and mechanisms are emphasized. In addition to providing details pertaining to the state-of-the-art current practice, innovative and emerging applications are discussed in specific chapters. Finally, the textbook provides specific chapters focusing on the technical aspects of the various neuromodulation procedures as well as technical specifications of various implantable devices. All of the contributors to Neuromodulation represent leading experts in the field. The editors are internationally renowned in their respective fields of neuromodulation, pain management, functional neurosurgery and biomedical engineering. Neuromodulation will be the first and foremost authoritative text on neuromodulation therapies and will establish the gold standard that defines the field for years to come. Key Features The first comprehensive reference on the emerging field of Neuromodulation Editors and authors include all leading figures in the field, and the leaders of the International Neuromodulation Society Over 90 chapters on topics ranging from a layout of the fundamentals (e.g. neuroanatomy, plasticity, bioelectrical effects, infusion therapies), solutions for the biomedical engineering challenges (e.g. materials, how to preserve normal function etc.), to a rundown of the existing applications and their future promise Over 1200 pages in splendid full color, richly illustrated Important areas of application include: control of chronic pain delivery of drugs to the nervous system via implanted devices control of epilepsy, Parkinson, etc. functional restoration, e.g. visual, auditory, restoration after stroke, restoration of motor function after traumatic events stimulation of body organs via neural devices (incl. the heart, abdominal organs, genitourinary organs) overview over newly emerging fields - control of obesity, blood pressure, tinnitus, brain injury, neurodegenerative diseases, brain-machine interfaces

Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the development of new diagnostic and therapeutic approaches has been disappointingly slow. Translational Research in Traumatic Brain Injury attempts to integrate expertise from across specialties to address knowledge gaps in the field of TBI. Its chapters cover a wide scope of TBI research in five broad areas: Epidemiology Pathophysiology Diagnosis Current treatment strategies and sequelae Future therapies Specific topics discussed include the societal impact of TBI in both the civilian and military populations, neurobiology and molecular mechanisms of axonal and neuronal injury, biomarkers of traumatic brain injury and their relationship to pathology, neuroplasticity after TBI, neuroprotective and neurorestorative therapy, advanced neuroimaging of mild TBI, neurocognitive and psychiatric symptoms following mild TBI, sports-related TBI, epilepsy and PTSD following TBI, and more. The book integrates the perspectives of experts across disciplines to assist in the translation of new ideas to clinical practice and ultimately to improve the care of the brain injured patient.

Based on advances in biotechnology and neuroscience, non-invasive neuromodulation devices are poised to gain clinical importance in the coming years and to be of increasing interest to patients, clinicians,health systems, payers, and industry. Evidence suggests that both therapeutic and non-therapeutic applications of non-invasive neuromodulation will continue to expand in coming years, particularly for indications where treatments are currently insufficient, such as drug-resistant depression. Given the growing interest in non-invasive neuromodulation technologies, the Institute of Medicine's Forum on Neuroscience and Nervous System Disorders convened a workshop, inviting a range of stakeholders - including developers of devices and new technologies, researchers, clinicians, ethicists, regulators, and payers - to explore the opportunities, challenges, and ethical questions surrounding the development, regulation, and reimbursement of these devices for the treatment of nervous system disorders as well as for non-therapeutic uses, including cognitive and functional enhancement. This report highlights the presentation and discussion of the workshop.