We use Starstim AC (alternative current) -Stimulator R32. FPS protocol will be used with 20 minutes 2mAmp 6 Hz tACS to the middle frontal gyrus (DLPFC, F4 in EEG electrodes with 10-20 system measurement) and inferior parietal cortex (IPC, P4), as the main nodes of the frontoparietal network, in synchronous oscillation. The 4 return electrodes will receive 0.5 mAmp each around each active electrode (High Definition Montage). The electrodes are silver/silver chloride that are wet with conductive gel. We will use surface landmarks and EEG caps on the head to place the electrodes, which are held in place by head caps with holes indicating places for electrode positioning.

In the sham stimulation mode, the device shows pseudorandom numbers on the screen that look like real stimulation is being delivered. The device gives a low level of stimulation at the very beginning and at the very end of the stimulation session (30 seconds ramp up and 30 seconds ramp down) in order to recreate the feeling of tingling that subjects perceive at the beginning and end of real stimulation.

Opioid-use Disorder

The tACS stimulator delivers very low (2mAmp) current with surface electrodes to the skull.

Transcranial Alternating Current Stimulation (tACS)

Laureate Institute for Brain Research

Frontoparietal Synchronization to Modulate Drug Craving in Opioid Use Disorder

Frontoparietal Synchronization to Modulate Drug Craving in Opioid Use Disorder: A Randomized Experimental Trial

Drug Cue Reactivity BOLD Signal is measured as average blood oxygen level dependent (BOLD) signal difference with voxel-wise analysis in the regions of interests (ROIs) (prefrontal cortex parcels, insula segments, striatum nuclei, thalamus nuclei and extended amygdala nuclei) in craving > neutral contrast in drug cue exposure fMRI task with blocks of neutral and drug related images

Drug cue reactivity self-report is measured as the difference in subjective response to "On a scale of 0-100, How much drug craving are you experiencing right now" measured on a visual analog scale (0-100) before and after drug cue exposure fMRI task. Higher reduction in this outcome in active group compared to sham means a better outcome.

Cortical-Subcortical Connectivity is measured as correlation between resting-state average blood oxygen level dependent (BOLD) signal time series in subcortical ROIs and voxels within prefrontal cortex and Insula

Cortical-subcortical task-based connectivity in cue exposure fMRI is measured as psychophysiological interaction (PPI) between average blood oxygen level dependent (BOLD) signal time series in subcortical ROIs and voxels within prefrontal cortex and insula, using craving > neutral contrast regressor

Resource Allocation Index (RAI) is measured with the correlation among default mode network (DMN), saliency network (SN) and Executive Control Network (ECN) in resting state fMRI based on Lerman, et al., 2014.

Area under electrode connectivity is measured with voxel-wise correlation between average blood oxygen level dependent (BOLD) signal in the cortical area under the Anode and Cathode electrodes and whole brain

Area under electrode task-based connectivity is measured with voxel-wise Psychophysiological Interaction (PPI) between average blood oxygen level dependent (BOLD) signal in the cortical area under the Anode and Cathode electrodes and whole brain using craving > neutral contrast regressor in block-design drug cue exposure fMRI task

Momentary craving self-report is assessed with subjective response to "On a scale of 0-100, How much drug craving are you experiencing right now" measured on a visual analog scale (0-100)

Drug cue control response is measured as the difference in subjective response to "On a scale of 0-100, How much CONTROL over your drug craving are you experiencing right now" measured on a visual analog scale (0-100) before and after drug cue exposure fMRI task

Laureate Institute for Brain Research, Inc.

Brain & Behavior Research Foundation

Local infiltration under general anesthesia via laryngeal mask

Spinal anesthesia with 15 mg of 0.5% hyperbaric bupivacaine

Quality of Life

Pain, Postoperative

Personal Satisfaction

Postoperative Complication

General anesthesia willl be induced with propofol 2 mg mg. kg-1 and alfentanyl 30 mcg.kg-1. Once an appropriate depth of anesthesia had been obtained, a laryngeal mask airway (LMA) will be positioned. The anesthesia will be maintained by propofol 4 to 5 mg. kg-1.h-1. Ventilation will controlled by adjusting the flow volume and respiratory rate to keep the end-tidal CO2 level (PETCO2) between 30 and 40 mmHg. For local anesthesia, approximately 50 ml of 0.5% ropivacaive will infiltrated along the line of incision in the subcutaneous plane, followed by peripheral nerve block technique (e.g., ilioinguinal-hypogastric nerve block) and local wound infiltration at the fascial level.

Local Group

Spinal puncture will be performed with the patient in the sitting position, using 27G disposable Quincke needles (B. Braun, Meisungen, AG). After obtaining CSF, 15 mg of 0.5% hyperbaric bupivacaine will be injected.

Spinal anesthesia

Santa Lucinda Hospital

Quality of Recovery After General or Spinal Anesthesia for Inguinal Hernia Repair

Quality of Recovery After Local Infiltration Under General Anesthesia Via Laryngeal Mask or Spinal Anesthesia for Inguinal Hernia Repair.

The quality of postoperative functional recovery will be assessed by the QoR-40 questionnaire, which assesses five dimensions of recovery (physical comfort - 12 items; emotional state - 7 items; physical independence - 5 items; physiological support - 7 items; and pain - 7 items). Each item was rated on a five-point Likert scale: none of the time, some of the time, usually, most of the time, and all the time. The total score on the QoR-40 ranges from 40 (poorest quality of recovery) to 200 (best quality of recovery).

Pain will be assessed every 15 minutes using a 0-10 numeric pain rating scale, where zero meant no pain and 10 the worst imaginable pain. Intravenous morphine (1 to 2 mg) will be administered every 15 minutes to maintain the pain score below 4 (1 mg when the pain score was <7 and 2 mg when it was ≥7). Postoperative pain relief in the ward was accomplished by i.v. ketoprofen (100 mg) every 12 hours, dipyrone (30 mg.kg-1, maximum 1 g) every six hours and tramadol (100 mg) at eight-hour minimum intervals as needed whenever patients judge that their analgesia is insufficient.

Occurrence of nausea, vomiting, shivering, urinary retention

Eduardo Toshiyuki Moro

Professor

Pontificia Universidade Catolica de Sao Paulo

Stimulation parameters : Dorso lateral prefrontal cortex,1HZ,600 pulses per session,15 sessions

Pathological Gambling

Real Deep TMS

Sham Deep TMS

Beer Yaakov Mental Health Center

Deep Low-Frequency Repetitive Transcranial Magnetic Stimulation for Cessation of Pathological Gambling

The South Oaks Gambling Screen is a 20-item questionnaire based on Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) criteria for pathological gambling.

A scale for assessment of pathological gambling

An instrument for assessment of desire to indulge in gambling

A scale for assessment of compulsions and obsessions

A scale for assessment of global clinical improvement

A scale for assessment of Social Adaptation

Dr. Oded Rosenberg

BeerYaakov Mental Health Center

Bipolar Spectrum Disorder With Moderate-to- Severe Hypomania or Mild Mania

Divalproex

Placebo

University of Cincinnati Medical Center

Study of Divalproex Extended Release Monotherapy in Ambulatory Bipolar Spectrum Disorder With Moderate-to-Severe Hypomania or Mild Mania

"A Randomized, Double-Blind, Placebo-Controlled Study of Divalproex Extended Release Monotherapy in Ambulatory Bipolar Spectrum Disorder With Moderate-to- Severe Hypomania or Mild Mania"

substance dependence/cefalàlgia

Frontoparietal Synchronization to Modulate Drug Craving in Opioid Use Disorder

Quality of Recovery After General or Spinal Anesthesia for Inguinal Hernia Repair

Deep Low-Frequency Repetitive Transcranial Magnetic Stimulation for Cessation of Pathological Gambling

Study of Divalproex Extended Release Monotherapy in Ambulatory Bipolar Spectrum Disorder With Moderate-to-Severe Hypomania or Mild Mania

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