Publications

Several procedures have been developed to enhance the rehabilitation of stroke patients. However, most techniques struggle to promote sustained recovery in the months following the treatment. Therefore, it is essential to understand the mechanisms that can be harnessed during treatment to potentiate retention of benefits and sustained recovery. While stroke patients often suffer from thalamocortical dysrhythmia (TCD), a perturbation in alpha (8-13 Hz) rhythms caused by decreased excitation in the cortico-thalamic projections, the functional relevance of TCD in stroke patients is not yet clear. We propose that TCD can be counteracted by combining focal stimulation of the motor cortex with virtual-reality (VR) based rehabilitation, which engages distributed networks associated with goal-oriented behavior. Critically, we investigate whether this can be the key to promoting sustained recovery in stroke patients. We compare thalamocortical rhythms and behavioral recovery in patients receiving Sham and bilateral tDCS stimulation of the motor cortex during therapy with the Rehabilitation Gaming System (RGS). Our results reveal that patients in the tDCS group show a sustained recovery in all clinical scales up to three months post-treatment, as opposed to the Sham group. Furthermore, we demonstrate that the slowing down of alpha rhythms can be counteracted by transcranial direct-current stimulation (tDCS), with a particular role for enhancing the excitability of parietal areas. That said, we found no correlation between changes in alpha rhythms and motor recovery. On one hand, our findings suggest that sustained recovery can be potentiated by tDCS-enhanced VR-based rehabilitation. On the other hand, enhancing the excitability of parietal areas while recruiting brain networks associated with goal-oriented behavior can successfully counteract TCD, even though this is likely not the main driver of sustained motor recovery.

JTD Keywords: Activation, Alpha rhythms, Deep brain-stimulation, Direct-current stimulation, Excitatory-inhibitory balance, Guidelines, Human thalamus, Involvement, Motor recovery, Quality-of-life, Rehabilitation, Sensitivity, Stroke, Transcranial direct-current stimulation

When exposed to the oral environment, dental implants, like natural surfaces, become substrates for microbial adhesion and accumulation, often leading to implant-related infections-one of the main causes of implant failure. These failures impose significant costs on patients, clinicians, and healthcare systems. Despite extensive research, there is no consensus on the most effective protocol for managing peri-implantitis. Biomedical engineering has aimed to address this challenge by developing biocompatible implants with surface properties designed to enhance biological responses and reduce polymicrobial accumulation. Due to the complexity of interactions between implants and biological systems, no single material property can drive these processes. Instead, a combination of physical, chemical, and mechanical properties is required to ensure a safe and effective response. Antimicrobial coatings are developed either by incorporating antimicrobial agents onto surfaces or modifying the material's physicochemical properties. These coatings utilize a range of compounds for contact-killing or as drug-delivery systems. While biomaterials science has advanced rapidly in enhancing implant surfaces, these bioengineering techniques have progressed more rapidly than our understanding of the pathogenesis of implant infections. To bridge this gap, biomedical engineering must address emerging knowledge about implant infections, focusing on controlling microbial accumulation while simultaneously managing inflammatory responses to support tissue healing. This review critically evaluates current evidence on implant infection pathogenesis, antimicrobial coating technologies, and systematically assesses their in vivo (animal and human evidence) efficacy to guide future advancements in implant infection mitigation.

JTD Keywords: Antimicrobial, Bacterial adhesion, Biofilm formation, Biomaterials, Coating, Dental implant, Drug-deliver, Free-energy, In-vivo antibacterial, Infectio, Infection, Peri-implantitis, Pure titanium, Quality-of-life, Resistant staphylococcus-aureus, Titanium implant