{"id":4783,"date":"2025-10-30T17:17:20","date_gmt":"2025-10-30T16:17:20","guid":{"rendered":"https:\/\/dratelhemat.com\/neuromodulation\/"},"modified":"2025-10-30T17:19:11","modified_gmt":"2025-10-30T16:19:11","slug":"neuromodulation","status":"publish","type":"page","link":"https:\/\/dratelhemat.com\/en\/neuromodulation\/","title":{"rendered":"Neuromodulation"},"content":{"rendered":"\t\t
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Neuromodulation in Bonn:
TPS (Neurolith), tDCS & Vagus Nerve Stimulation<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Summary:<\/strong> Gentle, non-invasive, outpatient. In my practice, I combine modern neuromodulatory procedures based on the approach of SOZOBRAINCENTER.COM<\/a><\/strong>\u00a0to specifically influence dysregulated networks of the central and peripheral nervous system\u2014with the goal of reducing symptoms and improving everyday function.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Typical indications (selection):<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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  • \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\tParkinson's disease<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t
  • \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\tAlzheimer\u2019s disease and other dementias<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t
  • \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\tAmyotrophic lateral sclerosis (ALS)<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t
  • \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\tEpilepsy<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t
  • \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\tDepression (unipolar)<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t
  • \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\tSleep disorders\/insomnia<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t
  • \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\tAutism spectrum disorder<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t
  • \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\tInflammatory bowel disease (IBD; Crohn\u2019s disease, ulcerative colitis)<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t
  • \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\tMultiple sclerosis (MS)<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t
  • \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\tTic disorders (incl. Tourette syndrome)<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t
  • \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t(e.g., with central sensitization)<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    Why neuromodulation?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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    Neurological and psychiatric conditions are network dysfunctions<\/strong>\u2014not just lesions of single areas. Neuromodulation uses electrical, pulsed-ultrasonic, or vagal stimuli to modulate neuronal excitability, synaptic plasticity (incl. meta-\/homeostatic plasticity)<\/strong> and functional connectivity<\/strong>. This can lessen symptoms, open rehabilitation windows<\/strong>, and complement pharmacotherapy.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    Our procedures<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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    1) Transcranial Pulse Stimulation (TPS) with Neurolith\u00ae<\/b> (Storz Medical)<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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    Principle:<\/strong> Ultrashort acoustic pulses (pulsed ultrasound, non-thermal) are applied in a navigation-guided manner to cortical target regions. Mechanistic targets:<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    • \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\tneurovascular coupling<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t
    • \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\tBDNF-mediated plasticity<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t
    • \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\tnetwork reconnection<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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      Process:<\/p>\n

      <\/strong>– Precise target planning (history, findings, optionally imaging)
      – 6\u20138 sessions<\/strong> of 30\u201345 min, typically 2\u00d7\/week
      \n<\/strong>– Monitoring: clinical assessment and standardized scales<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      Use cases:<\/p>\n

      <\/strong>– cognitive impairment\/dementia
      – Parkinson\u2019s disease (akinesia\/freezing, executive functions)
      – depression
      – chronic pain
      \n<\/strong>– autism<\/strong><\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      Adverse effects:<\/strong> usually mild (brief head pressure, fatigue). No radiation exposure.<\/strong><\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      Evidence base:<\/strong> growing yet heterogeneous; biologically plausible, long-term data limited<\/strong> (emerging evidence<\/em>).<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      2) Transcranial Direct Current Stimulation (tDCS<\/b>, if needed HD-tDCS<\/b>)<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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      Principle:<\/strong> Weak direct currents (typically 1\u20132 mA<\/strong>) modulate cortical excitability (anodal, cathodal) and metaplasticity<\/strong>.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      Process:<\/p>\n

      <\/strong>– Montage according to target network (e.g., DLPFC<\/strong> for depression, M1\/S1<\/strong>\u00a0for pain, temporo-parietal for epilepsy\/tics)
      – 20\u201330 min<\/strong> per session; home-use devices<\/strong> after instruction; typically 2\u00d7\/day<\/strong>\u00a0per protocol
      – Synergy with cognitive-motor training (state-dependency) recommended<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      Use cases:<\/strong><\/p>\n

      – depression
      – chronic (low back) pain
      – epilepsy (add-on)
      – Parkinson\u2019s (motor\/FoG)
      – sleep regulation
      – executive functions in autism<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      Adverse effects:<\/strong> tingling\/itching under electrodes, rarely headache; no downtime<\/strong>.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      Evidence base:<\/strong> moderate for some indications (depression\/pain), exploratory for others. Protocoland outcome-driven.<\/strong><\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      3) Transcutaneous Vagus Nerve Stimulation (taVNS)<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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      Principle:<\/strong> Activation of vagal afferents modulates LC-noradrenergic<\/strong> and cholinergic anti-inflammatory<\/strong> pathways (the inflammatory reflex<\/em>).<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      Process:
      \n<\/strong>– Individual parameterization (frequency, pulse width, duty cycle)
      – 15\u201330 min<\/strong>, 3\u20137\u00d7\/week<\/strong>, home protocols after instruction
      – Monitoring: symptom scales, HRV<\/strong>, optionally inflammatory markers<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      Use cases:<\/strong><\/p>\n

      – depression\/anxiety
      – sleep disorders
      – IBD
      \n<\/strong>– epilepsy (add-on)
      – autonomic imbalance
      – pain<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      Adverse effects:<\/strong> usually mild (skin irritation, tingling, rarely cough\/throat irritation). Not<\/strong>\u00a0with implanted stimulators\/pacemakers without prior clearance.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      .<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      How we work<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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      1. Medical evaluation<\/strong>\u00a0(medication, comorbidities, contraindications, goal setting)
      2. Network targeting<\/strong> (clinical, optionally EEG\/functional measures)
      3. Therapy plan<\/strong> (TPS, tDCS\/HD-tDCS, taVNS\u2014alone or combined)
      4. Objective outcomes<\/strong>\u00a0(e.g., UPDRS, MoCA, BDI-II, PSQI, HRV, pain NRS<\/strong>)
      5. Follow-up & boosters<\/strong>\u00a0depending on response pattern<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      \n\n\t\t\t\t\t\tLegal notice (German HWG)<\/span>\n\t\t\t\n\t\t\t\t\t\t

      Procedures with limited evidence are provided as individual therapeutic trials<\/strong>. No promise of cure.<\/strong>\u00a0Benefits\/risks are discussed in detail in advance; any off-label use is transparently communicated.<\/p>\n<\/span>\n\t\t\t\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      Who is not<\/b> a good candidate?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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      – Pregnancy (relative, depending on procedure)
      – Uncontrolled epilepsy<\/strong>\u00a0for certain protocols, acute psychosis
      – Active skin inflammation at electrode sites
      – Implanted electronic devices<\/strong>\u00a0(e.g., pacemaker), case-by-case clearance<\/strong><\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      <\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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      Frequently asked questions (FAQ)<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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      How quickly does treatment work?
      \n<\/strong>First effects often after 3\u20136 sessions<\/strong>; consolidation with full cycles and adjunct training.<\/p>\n

       <\/p>\n

      Can it be combined with medication?
      \n<\/strong>Yes\u2014dose adjustments are medically supervised.<\/p>\n

       <\/p>\n

      Is it painful?<\/strong>
      Generally no\u2014occasional transient sensations may occur.<\/p>\n

       <\/p>\n

      Will insurance cover it?<\/strong>
      Mostly self-pay\/private<\/strong>. Case-by-case reimbursement may be possible.<\/p>\n

       <\/p>\n

      How do we measure success?
      \n<\/strong>Standardized scales (UPDRS, MoCA, BDI-II, PSQI), HRV, pain NRS<\/strong>, and functional goals.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

      \n\t\t\t\t
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      <\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

      Neuromodulation in Bonn:TPS (Neurolith), tDCS & Vagus Nerve Stimulation Summary: Gentle, non-invasive, outpatient. In my practice, I combine modern neuromodulatory procedures based on the approach of SOZOBRAINCENTER.COM\u00a0to specifically influence dysregulated networks of the central and peripheral nervous system\u2014with the goal of reducing symptoms and improving everyday function. Typical indications (selection): Parkinson’s disease Alzheimer\u2019s disease and […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"ocean_post_layout":"","ocean_both_sidebars_style":"","ocean_both_sidebars_content_width":0,"ocean_both_sidebars_sidebars_width":0,"ocean_sidebar":"0","ocean_second_sidebar":"0","ocean_disable_margins":"enable","ocean_add_body_class":"","ocean_shortcode_before_top_bar":"","ocean_shortcode_after_top_bar":"","ocean_shortcode_before_header":"","ocean_shortcode_after_header":"","ocean_has_shortcode":"","ocean_shortcode_after_title":"","ocean_shortcode_before_footer_widgets":"","ocean_shortcode_after_footer_widgets":"","ocean_shortcode_before_footer_bottom":"","ocean_shortcode_after_footer_bottom":"","ocean_display_top_bar":"default","ocean_display_header":"default","ocean_header_style":"","ocean_center_header_left_menu":"0","ocean_custom_header_template":"0","ocean_custom_logo":0,"ocean_custom_retina_logo":0,"ocean_custom_logo_max_width":0,"ocean_custom_logo_tablet_max_width":0,"ocean_custom_logo_mobile_max_width":0,"ocean_custom_logo_max_height":0,"ocean_custom_logo_tablet_max_height":0,"ocean_custom_logo_mobile_max_height":0,"ocean_header_custom_menu":"0","ocean_menu_typo_font_family":"0","ocean_menu_typo_font_subset":"","ocean_menu_typo_font_size":0,"ocean_menu_typo_font_size_tablet":0,"ocean_menu_typo_font_size_mobile":0,"ocean_menu_typo_font_size_unit":"px","ocean_menu_typo_font_weight":"","ocean_menu_typo_font_weight_tablet":"","ocean_menu_typo_font_weight_mobile":"","ocean_menu_typo_transform":"","ocean_menu_typo_transform_tablet":"","ocean_menu_typo_transform_mobile":"","ocean_menu_typo_line_height":0,"ocean_menu_typo_line_height_tablet":0,"ocean_menu_typo_line_height_mobile":0,"ocean_menu_typo_line_height_unit":"","ocean_menu_typo_spacing":0,"ocean_menu_typo_spacing_tablet":0,"ocean_menu_typo_spacing_mobile":0,"ocean_menu_typo_spacing_unit":"","ocean_menu_link_color":"","ocean_menu_link_color_hover":"","ocean_menu_link_color_active":"","ocean_menu_link_background":"","ocean_menu_link_hover_background":"","ocean_menu_link_active_background":"","ocean_menu_social_links_bg":"","ocean_menu_social_hover_links_bg":"","ocean_menu_social_links_color":"","ocean_menu_social_hover_links_color":"","ocean_disable_title":"default","ocean_disable_heading":"default","ocean_post_title":"","ocean_post_subheading":"","ocean_post_title_style":"","ocean_post_title_background_color":"","ocean_post_title_background":0,"ocean_post_title_bg_image_position":"","ocean_post_title_bg_image_attachment":"","ocean_post_title_bg_image_repeat":"","ocean_post_title_bg_image_size":"","ocean_post_title_height":0,"ocean_post_title_bg_overlay":0.5,"ocean_post_title_bg_overlay_color":"","ocean_disable_breadcrumbs":"default","ocean_breadcrumbs_color":"","ocean_breadcrumbs_separator_color":"","ocean_breadcrumbs_links_color":"","ocean_breadcrumbs_links_hover_color":"","ocean_display_footer_widgets":"default","ocean_display_footer_bottom":"default","ocean_custom_footer_template":"0","footnotes":""},"class_list":["post-4783","page","type-page","status-publish","hentry","entry"],"yoast_head":"\nNeuromodulation - Dr. Atel Hemat<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dratelhemat.com\/neuromodulation-bonn\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Neuromodulation - Dr. Atel Hemat\" \/>\n<meta property=\"og:description\" content=\"Neuromodulation in Bonn:TPS (Neurolith), tDCS & Vagus Nerve Stimulation Summary: Gentle, non-invasive, outpatient. 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