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Neuromodulation: Journal of the International Neuromodulation Society

Peter M Kreuzer, Jonathan Downar, Dirk de Ridder, Jens Schwarzbach, Martin Schecklmann, Berthold Langguth
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) has become increasingly popular during the last decades mainly driven by the antidepressant effects of dorsolateral prefrontal cortex stimulation with "butterfly" coils. Only recently, alternative targets such as the dorsomedial prefrontal cortex (dmPFC) have been brought into focus and innovative coil designs such as the angled geometry of the double cone coil (DCC) have raised hope to reach even deeper located targets...
November 8, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Thomas M Kinfe, Rene Hurlemann
No abstract text is available yet for this article.
November 5, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Tarun Prabhala, Vignessh Kumar, Eric Gruenthal, Claire Collison, Julia Prusik, Stephanie Owusu, Ellie Hobson, Sarah E McCallum, Julie G Pilitsis
INTRODUCTION: Preoperative work-up for spinal cord stimulation (SCS) includes a psychological assessment; however, no one psychological factor has correlated with poor outcomes across studies. We developed a Psychological Evaluation Tool for Spinal Cord Stimulation Candidacy (PETSCSC), which includes all factors in the literature found to correlate with outcomes. In this study, we examine whether PETSCSC correlates with postoperative outcomes. METHODS: Patients undergoing SCS were prospectively enrolled in this study...
October 31, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Weston Nadherny, Brooke Anderson, Alaa Abd-Elsayed
INTRODUCTION: There are an ever-increasing number of patients who have implanted devices for targeted delivery of drug therapy to the intrathecal space for the management of spasticity or chronic pain. This leads to a growing number of people with implanted pumps presenting for procedures and surgeries, yet there is a paucity of consolidated information available to describe the appropriate precautions and patient management during this period. METHODS: This was a systematic review to provide a summary of existing literature on intrathecal drug delivery system (IDDS) management in the perioperative and procedural period, and to highlight additional areas that require further research...
October 31, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Primavera A Spagnolo, Han Wang, Prachaya Srivanitchapoom, Melanie Schwandt, Markus Heilig, Mark Hallett
OBJECTIVE: To evaluate the safety and efficacy of low-frequency, inhibitory, deep rTMS with a novel H-coil specifically designed to stimulate the insula. METHODS: In a randomized, crossover order, 16 healthy volunteers underwent two sessions (sham; active) of 1 Hz repetitive TMS at an intensity of 120% of individual motor threshold, over the right anterior insular cortex localized using a neuronavigation system. Before, immediately after, and one hour after rTMS, subjects performed two tasks that have previously been shown in fMRI experiments to activate insular cortex: A blink suppression task and a forced-choice risk-taking task...
October 29, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Nadine Gravius, Shafqat R Chaudhry, Sajjad Muhammad, Azize Boström, Sascha Gravius, Thomas Randau, Dirk Scheele, Philipp Westhofen, Johannes Kruppenbacher, Birgit Stoffel-Wagner, Christian Maier, Anna Weidlich, Thomas L Yearwood, Krishnan V Chakravarthy, Jeffery M Kramer, Rene Hurlemann, Thomas M Kinfe
OBJECTIVES: Complex regional pain syndrome (CRPS) and associated comorbidities have been linked to a pro-inflammatory state driven by different mediators. Targeted dorsal root ganglion stimulation (DRGSTIM ) suppressed pain levels and improved functional capacity in intractable CRPS. However, clinical trials assessing the impact of DRG stimulation on the neuroimmune axis are lacking. METHODS: This study enrolled 24 subjects (12 refractory CRPS patients plus suitably matched healthy controls) and performed immunoassays of inflammatory mediators in saliva and serum along with score-based assessments of pain, mood, and sleep quality at baseline and after three months of selective L4-DRGSTIM ...
October 25, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Ludovic Langlois, Marlène Antor, Karim Atmani, Erwan Le Long, Pierre Merriaux, Valérie Bridoux, Pierre Dechelotte, Anne Marie Leroi, Mathieu Meleine, Guillaume Gourcerol
OBJECTIVES: Sacral nerve stimulation (SNS) is a surgical treatment of urinary and fecal incontinence. Despite its clinical efficacy, the mechanisms of action of SNS are still poorly known. This may be related to the use of acute stimulation models. Up to date, no rodent model of chronic SNS implants has been developed. Therefore, the aim of this study was to create a fully implantable and remotely controllable stimulating device to establish an animal model of chronic SNS. MATERIALS AND METHODS: The stimulating device consisted of an implantable pulse generator linked to a platinum electrode...
October 22, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Jessica Tarn, Sarah Legg, Sheryl Mitchell, Bruce Simon, Wan-Fai Ng
OBJECTIVES: Primary Sjögren's syndrome (pSS) sufferers have rated chronic fatigue as the most important symptom needing improvement. Emerging data suggest that stimulation of the vagus nerve can modulate immunological responses. The gammaCore device (electroCore), developed to stimulate the cervical vagus nerve noninvasively, was used to assess the effects of vagus nerve activation on immune responses and clinical symptoms of pSS. MATERIALS AND METHODS: Fifteen female pSS subjects used the nVNS device twice daily a 26-day period...
October 17, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Laura Demartini, Gaetano Terranova, Massimo A Innamorato, Alessandro Dario, Michele Sofia, Carlo Angelini, Genni Duse, Amedeo Costantini, Matteo L G Leoni
BACKGROUND: Spinal cord stimulation (SCS) is a well-known treatment in patients with failed back surgery syndrome (FBSS). Burst stimulation is a recently developed stimulation modality that seems to be superior to tonic stimulation. METHODS: This observational multicenter study compared tonic and burst stimulation during a trial period in patients with FBSS or radiculopathy. All the patients enrolled underwent two weeks of tonic stimulation followed by another two weeks of BurstDR stimulation, without randomization...
October 17, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Tarun Prabhala, Shelby Sabourin, Marisa DiMarzio, Michael Gillogly, Julia Prusik, Julie G Pilitsis
OBJECTIVE: Spinal cord stimulation (SCS) has been shown to be effective in treating chronic pain in patients with varying etiologies. However, the impact of pharmacological treatment on augmenting response to SCS has not been previously studied. METHODS: We enrolled 108 patients who had undergone SCS surgery and documented their pain preoperatively and at 12 months postoperatively using the Numeric Rating Scale (NRS), McGill Pain Questionnaire (MPQ), Beck Depression Inventory (BDI), Oswestry Disability Index (ODI), Pain Catastrophizing Scale (PCS), and Global Impression of Change (GIC)...
October 16, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Roy S Hwang, Vishad Sukul, Claire Collison, Julia Prusik, Julie G Pilitsis
BACKGROUND: Intrathecal (IT) Baclofen is beneficial for spasticity, but if pumps become infected necessitating removal, baclofen withdrawal is difficult to manage and life-threatening. Furthermore there is no consistency between dosing and severity of withdrawal. Case reports detail full baclofen withdrawal at dosages of 260 μg/day. OBJECTIVE: To demonstrate that in patients on stable IT baclofen for prolonged periods, externalizing a patient's original IT pump is a safe, effective way to wean IT doses...
October 16, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Kaare Meier, Anne Lene Høst Knudsen, Shellie Ann Boudreau, Jens Christian Hedemann Sørensen
OBJECTIVES: In spinal cord stimulation (SCS), the electrical stimulation of the spinal cord with an implanted lead evokes a tingling peripheral sensation known as paresthesias. Newer stimulation paradigms allow paresthesia-free treatment, but during the implantation of the lead, paresthesias must cover the painful area to achieve optimal treatment effect. The localization of the evoked paresthesias can be difficult to accurately describe for the patient, and furthermore depends on a complex and only partially predictable set of parameters that includes the anatomical localization and the programming of the electrical field...
October 16, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Aladine A Elsamadicy, Bilal Ashraf, Xinru Ren, Amanda R Sergesketter, Lefko Charalambous, Hanna Kemeny, Tiffany Ejikeme, Siyun Yang, Promila Pagadala, Beth Parente, Jichun Xie, Theodore N Pappas, Shivanand P Lad
OBJECTIVES: Chronic pain (CP) affects a significant number of patients following hernia repair, ranging from 11 to 54% in the literature. The aim of this study was to assess the prevalence, overall costs, and health care utilization associated with CP after hernia repair. MATERIALS AND METHODS: A retrospective longitudinal study was performed using the Truven MarketScan® data base to identify patients who develop chronic neuropathic posthernia repair pain from 2001 to 2012...
October 15, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Krishnan V Chakravarthy, Fang Xing, Kelly Bruno, Alexander R Kent, Adil Raza, Rene Hurlemann, Thomas M Kinfe
BACKGROUND: There is increasing literature evidence both clinically and experimentally on the existence of potent, adaptive interactions between the central and peripheral aspects of the neuroimmune system in the genesis and maintenance of chronic neuropathic extremity pain and nociceptive back pain. The neuroinflammatory pathways are modulated by the interaction of pro- and anti-inflammatory cytokines and chemokines, which are released by peripheral immune system-derived cell species (macrophages and leukocytes)...
October 12, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Shankar Ramaswamy, Theresa Wodehouse, Richard Langford, Simon Thomson, Rod Taylor, Vivek Mehta
OBJECTIVES: Currently little objective evidence exists regarding the phenotype or somato-sensory profile of patients with Failed Back Surgery Syndrome (FBSS). The aim of this study is to characterize the somato-sensory profile of the patients with FBSS undergoing spinal cord stimulation (SCS). METHODS: A combined quantitative sensory test and questionnaire approach was used to characterize the somatosensory profiles of patients undergoing SCS. RESULTS: Baseline somatosensory profiles were obtained from 23 patients and full three-month data was obtained from 19 patients...
October 10, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Daivik B Vyas, Allen L Ho, David Y Dadey, Arjun V Pendharkar, Eric S Sussman, Robert Cowan, Casey H Halpern
OBJECTIVES: Cluster headaches are a set of episodic and chronic pain syndromes that are sources of significant morbidity for patients. The standard of care for cluster headaches remains medication therapy, however a minority of patients will remain refractory to treatment despite changes to dosage and therapeutic combinations. In these patients, functional neuromodulation using Deep Brain Stimulation (DBS) presents the opportunity to alleviate the significant pain that is experienced by targeting the neurophysiological substrates that mediate pain...
October 10, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Johannes Alexander Koeppen, Fahimeh Nahravani, Martin Kramer, Berthold Voges, Patrick Michael House, Alessandro Gulberti, Christian Karl Eberhard Moll, Manfred Westphal, Wolfgang Hamel
OBJECTIVE: Deep brain stimulation (DBS) of the anterior thalamic complex (ANT) is an adjunctive therapy for pharmacoresistant epilepsy. To define the most efficient target in DBS for epilepsy, we investigate clinical data, position of leads, usability of atlas data compared to electric field modeling based on programming parameters. METHODS: Data from ten consecutive patients who underwent ANT-DBS were analyzed. The mammillothalamic tract (MTT), an internal landmark for direct stereotactic targeting, was segmented from MRI...
October 8, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Jeffrey D Lewine, Kim Paulson, Nitin Bangera, Bruce J Simon
OBJECTIVES: The primary objective of this study was to explore the impact of noninvasive Vagal Nerve Stimulation (nVNS) on brain electrophysiology, as assessed through spontaneous resting-state EEG and stimulus-driven event-related potentials (ERPs). METHODS: A hand-held transcutaneous stimulator was placed on the neck over the main branch of the left vagus (active condition) or more laterally over neck muscles (sham condition), with two 120-sec long bursts of stimulation applied over a five-minute period...
October 4, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Yuanyuan Ding, Hongxi Li, Tao Hong, Rongjie Zhao, Peng Yao, Guangyi Zhao
OBJECTIVE: Pulsed radiofrequency (PRF) can relieve postherpetic neuralgia (PHN) caused by herpes zoster (HZ) infection. Nevertheless, its curative effect can vary and may be related to the duration of treatment period. The following study investigates the efficacy and safety of CT-guided PRF modulation on HZ neuralgia over different periods and different time points. MATERIALS AND METHODS: A total of 150 patients with HZ/PHN were enrolled at the Pain Department, Shengjing Hospital of China Medical University between January 2013 and December 2016...
October 4, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Argyrios Stampas, Radha Korupolu, Liang Zhu, Christopher P Smith, Kenneth Gustafson
OBJECTIVES: We investigated whether transcutaneous tibial nerve stimulation (TTNS) in acute spinal cord injury was safe and feasible, and could achieve neuromodulation and improve cystometrogram parameters during acute inpatient rehabilitation. MATERIALS AND METHODS: Participants were consecutive acute traumatic spinal cord injury patients admitted for acute inpatient rehabilitation, randomized to a 2-week trial of TTNS v sham stimulation. Primary outcomes were safety and feasibility of TTNS and secondary outcomes were bladder measures based on pre- and post-TTNS cystometrogram by group and within groups, including bladder capacity, detrusor hyperreflexia, pressures, and detrusor-sphincter dyssynergia, as well as filling sensations and desire to void...
October 3, 2018: Neuromodulation: Journal of the International Neuromodulation Society
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