Neuromodulation

What is neuromodulation?

Neuromodulation is a non-invasive and non-pharmacological technique that acts directly on the nerves to generate a natural biological response. It involves altering or modulating nerve activity using electrical currents applied directly to the target area. The side effects of neuromodular stimulation are limited compared to other invasive or pharmacological treatments known to treat spasticity and associated pain. In addition, it has clinically proven positive effects on range of motion, balance, hand-arm functions, and overall quality of life.

Non-invasive brain stimulation is a brain stimulation technique that is performed without the need for surgery or invasion into the body. There are different techniques to stimulate the brain non-invasively, but the best known are transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (tDCS). Both techniques play an important role in non-invasive neuromodulation by allowing the modification of brain activity in a safe and controlled manner, offering treatment alternatives for patients with neurological and psychiatric disorders who do not respond adequately to conventional pharmacological or therapeutic approaches.

In general, these stimulation techniques are used to treat different neurological disorders and to investigate brain function. They are safe and well-tolerated techniques, but must be performed by trained professionals and in an appropriate environment. In this sense, FIVAN recently published an article discussing the ethical limits in the application of transcranial electrical stimulation.

Neuromodulation Techniques we apply at FIVAN:

  1. TENS
  2. Exopulse Mollii Suit
  3. Bemer
  4. Non-invasive brain stimulation

Treatment with the Neuron Navigator

In recent years, Transcranial Magnetic Stimulation (TMS) and neuronavigation have been used together to investigate and modulate brain activity with greater precision. The neuronavigator is used to accurately locate the region of the brain to be stimulated with TMS and to guide the position of the magnetic stimulation coil. This allows for more precise and targeted stimulation of the brain region of interest.

In addition, some studies have used the neuronavigator to guide the placement of electroencephalography (EEG) electrodes during transcranial magnetic stimulation with simultaneous EEG (TMS-EEG). Precise electrode placement is important for obtaining high-quality EEG signals during transcranial magnetic stimulation.

The neuronavigator consists of several components, including a medical imaging acquisition system, a tracking system, and planning and navigation software. The medical imaging acquisition system, such as computed tomography (CT) and magnetic resonance imaging (MRI), is used to obtain detailed images of the patient’s brain. The tracking system uses sensors to track the movements of the patient and surgical instruments in real time. The planning and navigation software combines medical images and tracking information to create a three-dimensional representation of the patient’s brain, which is used to plan and guide the surgery.

Since 2017, FIVAN has been using The Neural Navigator neuronavigator in its treatments with Transcranial Magnetic Stimulation, providing greater precision, personalization and reproducibility to the treatment, which can improve the effectiveness and quality of the therapy and facilitate research in the field of brain stimulation.

Precision of TMS through the Neuron Navigator
Video - TMS through the Neuron Navigator

Benefits of neuronavigator

The neuronavigator provides the following benefits to TMS:

  1. Spatial precision: The neuronavigator uses magnetic resonance imaging (MRI) of the patient’s brain to guide the precise placement of the TMS coil in relation to the brain areas of interest. This improves the spatial precision of the stimulation and reduces variability between sessions.
  2. Treatment personalization: By using images of the patient’s brain, the neuronavigator allows the stimulation to be adapted to the individual brain anatomy. This facilitates the personalization of the treatment and the optimization of therapeutic results.
  3. Reproducibility: The neuronavigator allows to record and store the stimulation coordinates, which facilitates the reproduction of the placement of the TMS coil in subsequent sessions and guarantees the consistency of the treatment over time.
  4. Greater efficacy: The greater precision and personalization provided by the neuronavigator can increase the efficacy of TMS treatment, resulting in better clinical outcomes and a higher probability of therapeutic response.
  5. Research: In the context of research, the neuronavigator can be useful to explore the function of different brain areas and their connections, as well as to evaluate the effects of TMS on brain activity and cognitive function.