This thesis deals with the treatment of chronic pain by using neuromodulation, where a external generator is used in a trial period. In the first section the principle of pain management is described and then the main nature of neuromodulation. The possibilities of chronic pain suppression are described, where we are mainly dealing with neurostimulation (stimulation with electric current). For better understanding, examples of neurostimulation usage are shown, where and in what problems it is used. Because this work deals with an external generator for a trial period (a trial system), the possibilities of testing electric impulses are described, which are then used in a implantable generator IPG. The requirements for such a external generator are also described, which are important for the design of such a device. The design of the device is firstly modeled by a block scheme, where function of the separate blocks is described and afterwards, the entire design of the external generator for neuromodulation is given. The test sample of the external generator is manufactured and tested.

Background Epidural fibrosis (EF) is defined as nonphysiological scar formation, usually at the site of neurosurgical access into the spinal canal, in intimate vicinity to and around the origin of the radicular sheath. From the very onset, EF behaves as a reparative inflammation causing, as a rule, symptoms of characteristic nature and clinical course (pain). Treatment of epidural fibrosis causing failed back surgery syndrome (FBSS) by neuromadulation technique is very expensive. Finding of suitable parameters for the indication of treatment is therefore very important. Aims The study is based on evidence of the importance of epidural fibrosis for the development of chronic pain. Research is also focused on the comparison of the range fibrosis and the effect of stimulation (spinal cord stimulation - SCS). The goal is to find a suitable selection factor for the indication of neuromodulation. Methods I. A double-blind prospective study was conducted to investigate a cohort of 200 patients requiring surgical treatment for intervertebral disc hernia (hernia disci intervertebralis). The patients were randomly and blindly divided into 2 groups, one on peroperatively applied local doses of a mixture containing corticosteroids, the other without such medication. All the requirements of a double-blind...

Background Epidural fibrosis (EF) is defined as nonphysiological scar formation, usually at the site of neurosurgical access into the spinal canal, in intimate vicinity to and around the origin of the radicular sheath. From the very onset, EF behaves as a reparative inflammation causing, as a rule, symptoms of characteristic nature and clinical course (pain). Treatment of epidural fibrosis causing failed back surgery syndrome (FBSS) by neuromadulation technique is very expensive. Finding of suitable parameters for the indication of treatment is therefore very important. Aims The study is based on evidence of the importance of epidural fibrosis for the development of chronic pain. Research is also focused on the comparison of the range fibrosis and the effect of stimulation (spinal cord stimulation - SCS). The goal is to find a suitable selection factor for the indication of neuromodulation. Methods I. A double-blind prospective study was conducted to investigate a cohort of 200 patients requiring surgical treatment for intervertebral disc hernia (hernia disci intervertebralis). The patients were randomly and blindly divided into 2 groups, one on peroperatively applied local doses of a mixture containing corticosteroids, the other without such medication. All the requirements of a double-blind...

Background: Eating disorders are psychiatric illnesses whose treatment is difficult and usually the classic procedures fail. Recently, the number of researches in neuromodulatory methods has increased. I present an overview of basic stimulation methods, their use in the treatment of anorexia nervosa (AN), bulimia nervosa and binge-eating and the results of our study focused on the treatment of AN by transcranial direct current stimulation (tDCS). Methods: It was a randomized, double-blind, sham-controlled trial. Forty-three inpatients with AN were divided to receive either active (n=22) or sham (n=21) tDCS over the left DLPFC (anode F3/cathode Fp2, 2mA for 30 minutes). All patients filled the Eating Disorder Examination Questionnaire (EDE-Q) and Zung depression scale (ZUNG), we measured them the thermal pain threshold, the objective dissatisfaction with their own body by Anamorfic program and evaluated BMI before the first and after the last tDCS. Follow-up was after 2 and 4 weeks. It was evaluated using ANOVA and OPLS model. Results: Compared to sham tDCS, active tDCS improved self-evaluation based on one's body shape (p < 0,05) and significantly decreased the need of excessive control over calorie intake (p < 0,05) in 4-week follow-up (questions 4 and 23 in EDE-Q). Question 21 in EDE-Q was more...