Bipolar disorder is a debilitating psychiatric condition characterized by recurrent episodes of mania and depression, affecting millions worldwide. While pharmacotherapy remains the cornerstone of treatment, a significant proportion of patients exhibit inadequate response or intolerable side effects to conventional medications. In recent years, neuromodulation techniques have emerged as promising adjunctive or alternative treatments for bipolar disorder. We performed a narrative review to provide a comprehensive overview of the current literature on neuromodulation interventions in bipolar disorder across the course of lifespan. Specifically, it examines the efficacy, safety, and mechanisms of action of various neuromodulation strategies, including, among others, transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), deep brain stimulation (DBS), and it describes the therapeutic experiences across the different ages of illness. Additionally, this review discusses the clinical implications, challenges, and future directions of the integration, in the clinical practice, of neuromodulation into the management of bipolar disorder. By synthesizing evidence from different studies, this review aims to inform clinicians, researchers, and stakeholders about the evolving landscape of neuromodulation treatments and their potential role in improving outcomes for individuals with bipolar disorder.

Seizure development relies on two factors. One is the existence of an overexcitable neuronal network and the other is a trigger that switches normal activity of that network into a paroxysmal state. While mechanisms of local overexcitation have been the focus of many studies, the process of triggering remains poorly understood. We suggest that, apart from the known exteroceptive sources of reflex epilepsy – visual, auditory or olfactory, there is a range of interoceptive triggers, relevant for seizure development in Temporal Lobe Epilepsy (TLE). The hypothesis proposed here aims to explain the prevalence of epileptic activity in sleep and in drowsiness states and provide a detailed mechanism of seizure triggering by interoceptive signals.

General Variable Neighborhood Search (GVNS) is a well known and widely used metaheuristic for efficiently solving many NP-hard combinatorial optimization problems. Quantum General Variable Neighborhood Search (qGVNS) is a novel, quantum inspired extension of the conventional GVNS. Its quantum nature derives from the fact that it takes advantage and incorporates tools and techniques from the field of quantum computation. Travelling Salesman Problem (TSP) is a well known NP-Hard problem which has broadly been used for modelling many real life routing cases. As a consequence, TSP can be used as a basis for modelling and finding routes for Geographical Systems (GPS). In this paper, we examine the potential use of this method for the GPS system of garbage trucks. Specifically, we provide a thorough presentation of our method accompanied with extensive computational results. The experimental data accumulated on a plethora of symmetric TSP instances (symmetric in order to faithfully simulate GPS problems), which are shown in a series of figures and tables, allow us to conclude that the novel qGVNS algorithm can provide an efficient solution for this type of geographical problems.