Neuromodulation

Neuromodulation is a new promising treatment for headache disorders. It consists of peripheral nerve neurostimulation and central neurostimulation. © 2016, Touch Briefings. All rights reserved

Neuromodulation in neurogenic bladder.

While neuromodulation is a well-established treatment option for patients with non-neurogenic overactive bladder and urinary retention, its applicability to the neurogenic bladder population has only recently been examined more in depth. In this article we will discuss the outcomes, contraindications, and special considerations of sacral and percutaneous tibial nerve stimulation (PTNS) in patients with neurogenic lower urinary tract dysfunction

Intraspinal Drug Delivery Reservoir Refill Procedure by Non-Physician Clinicians: A Nation-Wide Survey of Training, Pocket Fill Experience, and Life-Long Learning Behaviors

Intraspinal drug delivery (IDD) is a safe and efficacious method used to deliver medications for the treatment of chronic neurologic disease that requires periodic reservoir refills that can place patients at risk for a rare, accidental but potentially life-threatening, pocket fill. In the United States (US), non-physician clinicians perform this procedure. This study reports the results of a nationwide survey completed by 65 non-physician clinicians, obtained through social media, who performed the reservoir refill procedure. The results of the survey showed no standardized training was used, lack of attention to existing clinical practice guidelines in the training given, lack of supervision and mentoring for inexperienced clinicians, an unexpected number of pocket fills, and limited participation in professional meetings where intraspinal therapy is discussed. Suggestions for improvement are given

Neural and Environmental Modulation of Motivation: What's the Moral Difference?

Interventions that modify a person’s motivations through chemically or physically influencing the brain seem morally objectionable, at least when they are performed nonconsensually. This chapter raises a puzzle for attempts to explain their objectionability. It first seeks to show that the objectionability of such interventions must be explained at least in part by reference to the sort of mental interference that they involve. It then argues that it is difficult to furnish an explanation of this sort. The difficulty is that these interventions seem no more objectionable, in terms of the kind of mental interference that they involve, than certain forms of environmental influence that many would regard as morally innocuous. The argument proceeds by comparing a particular neurointervention with a comparable environmental intervention. The author argues, first, that the two dominant explanations for the objectionability of the neurointervention apply equally to the environmental intervention, and second, that the descriptive difference between the environmental intervention and the neurointervention that most plausibly grounds the putative moral difference in fact fails to do so. The author concludes by presenting a trilemma that falls out of the argument

Using the maternal immune stimulation model of schizophrenia to investigate the therapeutic efficacy of neuromodulation techniques

The present work used a neurodevelopmental rodent model of schizophrenia, namely the maternal immune stimulation (MIS) model, to study the potency of electrical neuromodulation techniques to ameliorate and even prevent schizophrenia-relevant behavioral and neurobiological abnormalities. Acute and focal deep brain stimulation (DBS) to the medial prefrontal cortex (mPFC) was found to be therapeutically relevant as it successfully normalized deficits in sensorimotor gating and attention selectivity apparent in the adult MIS animals. Using a longitudinal approach the development of sensorimotor gating deficits in the MIS model was traced and was found to exhibit a maturational delay, in accordance with the clinical situation. Further, this approach revealed aberrant neurochemistry profile in the mPFC during the pre-symptomatic period of adolescence, prior to the outbreak of the behavioral deficits. Thus, chronic DBS to the mPFC of adolescent MIS animals was tested and revealed that this approach could prevent the development of deficits in sensorimotor gating, attentional selectivity and reversal learning. Along with these effects, DBS was able to prevent increased lateral ventricles volume and neurochemical alterations as well as the prevention of altered microglia in this model. Finally, a non-invasive neuromodulation technique in the form of transcranial direct current stimulation (tDCS) was chronically applied during adolescence to the prefrontal cortex and revealed that tDCS prevented behavioral deficits belonging to the positive-symptomatology of schizophrenia, along with abnormal lateral ventricles volume. Taken together, this pre-clinical, translational-directed work points to the plausible efficacy of early, non-invasive, neuromodulation approach as a preventive measure for the development of schizophrenia

Diffusion-based neuromodulation can eliminate catastrophic forgetting in simple neural networks

A long-term goal of AI is to produce agents that can learn a diversity of skills throughout their lifetimes and continuously improve those skills via experience. A longstanding obstacle towards that goal is catastrophic forgetting, which is when learning new information erases previously learned information. Catastrophic forgetting occurs in artificial neural networks (ANNs), which have fueled most recent advances in AI. A recent paper proposed that catastrophic forgetting in ANNs can be reduced by promoting modularity, which can limit forgetting by isolating task information to specific clusters of nodes and connections (functional modules). While the prior work did show that modular ANNs suffered less from catastrophic forgetting, it was not able to produce ANNs that possessed task-specific functional modules, thereby leaving the main theory regarding modularity and forgetting untested. We introduce diffusion-based neuromodulation, which simulates the release of diffusing, neuromodulatory chemicals within an ANN that can modulate (i.e. up or down regulate) learning in a spatial region. On the simple diagnostic problem from the prior work, diffusion-based neuromodulation 1) induces task-specific learning in groups of nodes and connections (task-specific localized learning), which 2) produces functional modules for each subtask, and 3) yields higher performance by eliminating catastrophic forgetting. Overall, our results suggest that diffusion-based neuromodulation promotes task-specific localized learning and functional modularity, which can help solve the challenging, but important problem of catastrophic forgetting

A Roadmap for Integrating Neuroscience into Addiction Treatment:A Consensus of the Neuroscience Interest Group of the International Society of Addiction Medicine

Although there is general consensus that altered brain structure and function underpins addictive disorders, clinicians working in addiction treatment rarely incorporate neuroscience-informed approaches into their practice. We recently launched the Neuroscience Interest Group within the International Society of Addiction Medicine (ISAMNIG) to promote initiatives to bridge this gap. This article summarises the ISAM-NIG key priorities and strategies to achieve implementation of addiction neuroscience knowledge and tools forthe assessment and treatment of substance use disorders. We cover two assessment areas: cognitive assessment and neuroimaging, and two interventional areas: cognitive training/remediation and neuromodulation, where we identify key challenges and proposed solutions. We reason that incorporating cognitive assessment into clinical settings requires the identification of constructs that predict meaningful clinical outcomes. Other requirements are the development of measures that are easily-administered, reliable and ecologically-valid. Translation of neuroimaging techniques requires the development of diagnostic and prognostic biomarkers and testing the cost-effectiveness of these biomarkers in individualised prediction algorithms for relapse prevention and treatment selection. Integration of cognitive assessments with neuroimaging can provide multilevel targets including neural, cognitive, and behavioural outcomes for neuroscience-informed interventions. Application of neuroscience-informed interventions including cognitive training/remediation and neuromodulation requires clear pathways to design interventions based on multilevel targets, additional evidence from randomised trials and subsequent clinical implementation, including evaluation of cost-effectiveness. We propose to address these challenges by promoting international collaboration between researchers and clinicians, developing harmonised protocols and data management systems, and prioritising multi-site research that focuses on improving clinical outcomes

Born to learn: The inspiration, progress, and future of evolved plastic artificial neural networks

Biological plastic neural networks are systems of extraordinary computational capabilities shaped by evolution, development, and lifetime learning. The interplay of these elements leads to the emergence of adaptive behavior and intelligence. Inspired by such intricate natural phenomena, Evolved Plastic Artificial Neural Networks (EPANNs) use simulated evolution in-silico to breed plastic neural networks with a large variety of dynamics, architectures, and plasticity rules: these artificial systems are composed of inputs, outputs, and plastic components that change in response to experiences in an environment. These systems may autonomously discover novel adaptive algorithms, and lead to hypotheses on the emergence of biological adaptation. EPANNs have seen considerable progress over the last two decades. Current scientific and technological advances in artificial neural networks are now setting the conditions for radically new approaches and results. In particular, the limitations of hand-designed networks could be overcome by more flexible and innovative solutions. This paper brings together a variety of inspiring ideas that define the field of EPANNs. The main methods and results are reviewed. Finally, new opportunities and developments are presented