Background: Deep brain stimulation of the subthalamic nucleus (STN-DBS) and the pedunculopontine nucleus (PPN) significantly improve cardinal motor symptoms and postural instability and gait difficulty, respectively, in Parkinson’s disease (PD).Objective and Hypothesis: Intrinsic auricular muscle zones (IAMZs) allow the potential to simultaneously stimulate the C2 spinal nerve, the trigeminal nerve, the facial nerve, and sympathetic and parasympathetic nerves in addition to providing muscle feedback and control areas including the STN, the PPN and mesencephalic locomotor regions. Our aim was to observe the clinical responses to IAMZ stimulation in PD patients.Method: Unilateral stimulation of an IAMZ, which includes muscle fibers for proprioception, the facial nerve, and C2, trigeminal and autonomic nerve fibers, at 130 Hz was performed in a placebo- and sham-controlled, double-blinded, within design, two-armed study of 24 PD patients.Results: The results of the first arm (10 patients) of the present study demonstrated a substantial improvement in Unified Parkinson’s Disease Ratings Scale (UPDRS) motor scores due to 10 min of IAMZ electrostimulation (p = 0.0003, power: 0.99) compared to the placebo control (p = 0.130). A moderate to large clinical difference in the improvement in UPDRS motor scores was observed in the IAMZ electrostimulation group. The results of the second arm (14 patients) demonstrated significant improvements with dry needling (p = 0.011) and electrostimulation of the IAMZ (p < 0.001) but not with sham electrostimulation (p = 0.748). In addition, there was a significantly greater improvement in UPDRS motor scores in the IAMZ electrostimulation group compared to the IAMZ dry needling group (p < 0.001) and the sham electrostimulation (p < 0.001) groups. The improvement in UPDRS motor scores of the IAMZ electrostimulation group (ΔUPDRS = 5.29) reached moderate to high clinical significance, which was not the case for the dry needling group (ΔUPDRS = 1.54). In addition, both arms of the study demonstrated bilateral improvements in motor symptoms in response to unilateral IAMZ electrostimulation.Conclusion: The present study is the first demonstration of a potential role of IAMZ electrical stimulation in improving the clinical motor symptoms of PD patients in the short term.
Current Fourier transform infrared spectroscopy (FTIR) systems have very good spectral resolution, but are bulky, sensitive to vibrations, and slow. We developed a new FTIR system using a microelectromechanical system (MEMS)-based lamellar grating interferometer that is fast, compact, and achromatic (i.e., does not require a beam splitter). The MEMS device has >10 mm2 active surface area, up to ±325 μm mechanical displacement, and a 343 Hz resonant operation frequency. The system uses a 5 MHz bandwidth custom infrared (IR) detector and a small emission area custom blackbody source to achieve fast interferogram acquisition and compact form factor. Effects of lamellar grating period, detector size, laser reference, apodization, and averaging of data on the spectral resolution are discussed. The measurement time ranges from 1.5 to 100 ms depending on the averaging time. In the target range of 2.5-16 μm (625-4000 cm-1) a spectral resolution of 15-20 cm-1 is demonstrated. The measurements are shown to be stable over a long time.
Postoperative hypertension after radical neck dissection was detected in 20.2% of 109 neck dissections in our department between 1989 and 1993. It was probably caused by carotid sinus denervation and appeared after the vasodilation generated by anesthesia had subsided. If postoperative hypertension was encountered after the first operation, the risk of such hypertension after surgery on the contralateral side significantly increased.
This paper presents a laser based auto-stereoscopic 3D display technique and a prototype utilizing a dual projector light engine. The solution described is able to form dynamic exit pupils under the control of a multiuser head-tracker. A prototype completed recently is able to provide a glasses-free solution for a single user at a fixed position. At the end of the prototyping phase it is expected to enable a multiple user interface with an integration of the pupil tracker and the spatial light modulator.
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