valich said:
How does transdural motor cortex stimulation work? Is it for patients who are in a coma? Don't know anything about it.
When my right upper quadrant became paralyzed I used a TENS unit (tactile electro-neural stimulator) to help keep the motor neurns active and to prevent muscle atrophy, but after the pain syndrome set in, the TENS unit increased the nerve pain and I had to stop using it.
You ask about advances in China. I think I posted a reply on another link to you about the benefits of acupuncture? I'm not well versed in how it works, but I swear by it for physical pain. ....
The transdural stimulation was applied to the lower spinal cord, Lumbar section. Although it might be possible to apply it in some parts of the brain, it would never be applied to motor cortex. If that were done you would either have spasms or if the pulse frequency was more than about 2000 Hz, you probably would be paralized by it. Just anterior to the motor cortex is a motor related cortex. (If you remove a small section of the motor cortex, it can often learn to resume the damaged function - I have no idea what would happen if applied there with intact motor cortex.)
I think electrical stimulation has been used in many, if not most, other brain areas. I have made electrodes that were applied to the cerebral cortex of monkeys in a study of a possible therapy for epilepsy and a Dr. Cooper in Boston area was already implanting his in humans. (Epilepsy is a very tricky problem with considerable placebo effect in some cases, so we were not confident in his positive results.)
No one knows how acupuncture works. I have little belief in the theories associated with it, but the emprical information about there to apply it seems to be generally useful, if not "valid" by western science standards. I have seen films of very major abdomenal surgery on a obviously very alert patient who according to the film narration (and I believe it - although it might have been trick with high spinal block) only acupuncture for pain control.
I think it is still true that most western doctors have a low opinion of acupuncture, but I do not. It is sort of the medical communities version of the "not invented here syndrome" which makes it almost impossible to sell your technical invention to a major company. - Many will not even give your description to their scientist to consider it merits but send it to the legal department for them to issue their "we do not evaluator or read external submissions" letter - they correctly fear that if they are working on anything even vaguely related that comes to market later, the inventor will sue them for royalties, etc.) This line of thought does not to me, seem to apply in the case of acupuncture so I do not understand why Western Doctors reject it as strongly as they do - may have to do with the potential for reduction of drugs etc.
I called our transdural stimulation "electrical acupuncture" but that is not official. I suspect that both it and traditional acupuncture work basicly by the mechanism that Ben Gay (and other) mussel pain relievers work - a "counter irritations" or "distraction" continuous neural "assault" on the brain - I.e. a lot of neural input for it to process makes it less efficient in giving you pain. That is just my view, but perhaps others share it. It would explain why our transdural stimulation did permit great reduction in the sedatives etc for a few months and then failed to provide relief as the brain learned to not even bring to near conscious level the neural pulses provoked by the stimulation.
I have a patent in this field. Read remainder onlyif interested in that. - The dural electrode is somewhat flexible and long (still less than 1cm) but narrow so it can be slide down thru a rather large needle (type routinely used for "spinal taps"). Once it is in place, the needle is pulled back along the wires that will connect it to the implanted package that drives the electrode. To make this connection, the doctor had to solder the connector to the end of these wires in the sterile operating field. - it was a mess and took 10 or 15 minutes and was not a very reliable connection, but necessary as if the connector were already attached to these wires, you could still slide the electrode down thru the needle, but then could not pull the needle back as connector was much larger than the needle and stopped it.
I made a "dural insertion needle" in two pieces. One was "U" shaped and the other a flat "blade" that could be slide down the open edge of the stiff "U" cross-section main body of the needle to close the open side of the needle. After the electrode was in place, the cable was long enough (always was as the implanted driver unit was typically 20 or more cm away in the abdomen) for the needle to be fully withdrawn from the body and then disassemble into the two separate pieces so the cable could be removed from the open side of the part with U shaped cross-section.
This is a good illustration of why it is important for the medical instrument/ system designers to be in the operating room while the system is being perfected. Also it is a case where some developmental work must use humans who can communicate the results to you. (Hard to get monkey to tell you what set of pulse parameters is best etc., but I have also done a lot of work with monkeys.) I had an interesting 30 year career at APL - they let me do pretty much what I liked (energy and medical research with the doctors at JHU) and only occasionally asked me to do what APL mainly did in that era - help the US Navy solve its problems.
