Lifestyle intervention reduces type 2 diabetes incidence among young women with previous gestational diabetes: A randomized controlled trial.

Direct electrical stimulation of specific neural pathways can be used to target and treat a range of neurological and psychiatric disorders. The design of stimulation parameters can have a substantial impact on neural selectivity and energy efficiency and thus is important across clinical settings. The stimulation waveform can vary with respect to morphology, number of phases, polarity, intensity, pulse width, duration, frequency, and current versus voltage control []. Insufficient responses to stimulation-based therapies are partly due to inconsistencies in selected stimulation parameters compounded by a lack of understanding of input-output relationships []. Using single-pulse electrical stimulation (SPES) can help to unmask the influence of individual components. SPES is a promising technique to aid in parameter optimization due to its ability to map in vivo functional connectivity and dynamic brain network organization. Although SPES was historically used to map epileptic networks and identify seizure onset zones [–], its utility has expanded into explorations of brain organization more generally, as well as furthering our understanding of the mechanisms of stimulation-based neurotherapeutics. SPES is conducted using a series of individual pulses, and evoked potentials are measured at sites local and distant to the stimulation electrode contact. In this way, SPES can elucidate causal influence between brain regions with high spatiotemporal resolution (millisecond, millimeter) [,]. Each parameter of a stimulation waveform contributes to the resultant neural output. Computational models as well as in vivo and in vitro experiments have aided in demystifying relationships between input parameters and neural responses [,–]. Multi-compartment cable models suggest that orientation-specific selectivity can occur based on the selection of cathodic versus anodic stimulation []. Further, tuning the frequency of stimulation can induce neural suppression or excitation [,]. Also, increasing stimulation amplitude influences neuronal activation, affecting the magnitude of evoked responses and the volume of neural tissue activated (VTA) [].