Until recently, it was thought that the adult brain is modifiable only during early stages of ontogenesis. However, neurophysiological and neuroimaging studies now indicate that the mature human brain is, under certain conditions, capable of substantial neuroplastic changes. Neuroplasticity reflects the ability of the human brain to alter the pattern of neural activation in response to previous experience, and recent findings indicate that the effects of experience can lead to both structural as well as functional reorganization. It has been shown that pathological neuroplastic changes can be reverted/normalized and that the modulation of the neuroplastic changes can be paralleled by improvement of the patient's status. However, there is a gap between the potential of neuromodulation, technical progress and actual preparedness of medical personnel to provide this type of treatment. A prevalent opinion among medical professionals indicates that training programs and educational materials in neuromodulatory techniques are well needed and appreciated. Neuromodulation will focus on the description and discussion of methods currently available for invasive and non-invasive neuromodulation, their clinical potential, significance and practical applications. In order to facilitate understanding of the topic, the initial part of the textbook will review neurophysiological systems involved in neuromodulation and will provide readers with basic principles of neuroplasticity that constitutes the rationale for neuromodulation in human medicine. Additionally, the clinical use of these techniques will be described with special regard to safety and avoidance of complications.
Helena Knotkova, PhD is Co-Chief of the Research Division, Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York and Co-founder as well as Director of Research at Institute of Non-invasive Brain Stimulation of New York, and Assistant Professor of Neurology, Albert Einstein College of Medicine, Bronx, New York. She is a co-founder of the Special Interest Group on Neuromodulation under the International Association for the Study of Pain (IASP). Dirk Rasche, MD is a general Neurosurgeon and Assistant Professor of Neurosurgery, Department of Neurosurgery, University of Lübeck, Germany. Dr. Rasche is as an active member of IASP, EFIC, INS and multiple other international and national associations.
Principles of Neuromodulation.- Methods and Technologies for Low-Intensity Transcranial Electrical Stimulation: Waveforms, Terminology, and Historical Notes.- Peripheral Nerve Stimulation.- Spinal Cord Stimulation.- Dorsal Root Ganglion Stimulation: A Target for Neuromodulation Therapies.- Deep Brain Stimulation.- Motor Cortex Stimulation.- Physiological Basis of Transcranial Magnetic Stimulation.- Transcranial Direct Current Stimulation: Protocols and Physiological Mechanisms of Action.- Customization of Transcranial Direct Current Stimulation for Susceptible Populations Including at the Extremes of Age, Obesity, and Stroke.- Cranial Electrical Stimulation.- The Mechanisms and Actions of Motor Imagery Within the Clinical Setting.- Neuroprosthesis and Sensory-Motor Training.- Clinical Applications of Neuromodulation in Psychiatry.- Applications of Neuromodulation in Pain Management.- Applications of Neuromodulation in Neurology and Neurorehabilitation.- Neuromodulation for Addiction.- Enhancement of Sensory and Cognitive Functions in Healthy Subjects.- Conclusive Overview.