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Burst spinal cord stimulation.

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https://www.readbyqxmd.com/read/27906080/tonic-and-burst-spinal-cord-stimulation-waveforms-for-the-treatment-of-chronic-intractable-pain-study-protocol-for-a-randomized-controlled-trial
#1
Konstantin V Slavin, Richard B North, Timothy R Deer, Peter Staats, Kristina Davis, Roni Diaz
BACKGROUND: Burst stimulation is a novel form of neurostimulation for the treatment of chronic pain which has demonstrated promise in small uncontrolled studies, but has not yet gained approval for use in the U.S. We report the study methods for an ongoing multicenter, randomized, controlled, cross-over study designed to gain United States Food and Drug Administration (FDA) approval for burst stimulation. METHODS: Participants who are candidates for a currently approved neurostimulation device were enrolled and screened...
December 1, 2016: Trials
https://www.readbyqxmd.com/read/27881723/intraspinal-microstimulation-and-diaphragm-activation-following-cervical-spinal-cord-injury
#2
Lynne M Mercier, Elisa J Gonzalez-Rothi, Kristi A Streeter, Savannah S Posgai, Alexander S Poirier, David D Fuller, Paul J Reier, David M Baekey
Intraspinal microstimulation (ISMS), using implanted electrodes, can evoke locomotor movements after spinal cord injury (SCI), but has not been explored in the context of respiratory motor output. An advantage over epidural and direct muscle stimulation is the potential of ISMS to selectively stimulate components of the spinal respiratory network. The present study tested the hypothesis that medullary respiratory activity could be used to trigger mid-cervical ISMS and diaphragm motor unit activation in rats with cervical SCI...
November 23, 2016: Journal of Neurophysiology
https://www.readbyqxmd.com/read/27875377/spinal-cord-stimulation-for-refractory-angina-pectoris-a-systematic-review-and-meta-analysis
#3
Xiaoxiao Pan, Hongguang Bao, Yanna Si, Chenjie Xu, Hao Chen, Xianzhong Gao, Xinyi Xie, Yajie Xu, Fan Sun, Lingqing Zeng
OBJECTIVES: Parasthesia free stimulation, such as high frequency and burst have been demonstrated as effective therapies for neuropathic pain. The aim of this meta-analysis was to evaluate the efficacy and safety of conventional spinal cord stimulation (SCS) in the treatment of refractory angina pectoris (RAP). METHODS: Relevant randomized controlled trial (RCT) studies that investigated SCS for patients with RAP were comprehensively searched in Medline, Pubmed, Embase, and Cochrane Library...
November 21, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27834646/application-of-empirical-mode-decomposition-combined-with-notch-filtering-for-interpretation-of-surface-electromyograms-during-functional-electrical-stimulation
#4
Rakesh Pilkar, Mathew Yarossi, Arvind Ramanujam, Venkateswaran Rajagopalan, Mehmed Bugrahan Bayram, Megan Mitchell, Stephan Canton, Gail Forrest
GOAL: The goal of this paper is to demonstrate a novel approach that combines Empirical Mode Decomposition (EMD) with Notch filtering to remove the electrical stimulation (ES) artifact from surface electromyogram (EMG) data for interpretation of muscle responses during functional electrical stimulation (FES) experiments. METHODS: FES was applied to the rectus femoris (RF) muscle unilaterally of 6 able bodied (AB) and 1 individual with spinal cord injury (SCI). Each trial consisted of three repetitions of ES...
November 3, 2016: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/27714945/preferred-frequencies-and-waveforms-for-spinal-cord-stimulation-in-patients-with-complex-regional-pain-syndrome-a-multicentre-double-blind-randomized-and-placebo-controlled-crossover-trial
#5
N Kriek, J G Groeneweg, D L Stronks, D de Ridder, F J P M Huygen
BACKGROUND: Conventional tonic spinal cord stimulation (SCS) is an effective treatment for patients with therapy-resistant complex regional pain syndrome (CRPS). Although the therapeutic effect of SCS can diminish over time due to tolerance, pain control can be regained by changing the pulse width and the amplitude and/or by increasing the stimulation frequency. This multicentre, double-blind, randomized and placebo-controlled crossover trial was conducted to investigate whether more effective pain reduction is achieved with different frequencies (trial registration, current controlled trials, ISRCTN 36655259)...
October 7, 2016: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/27566051/effects-of-stand-and-step-training-with-epidural-stimulation-on-motor-function-for-standing-in-chronic-complete-paraplegics
#6
Enrico Rejc, Claudia A Angeli, Nicole Bryant, Susan J Harkema
Individuals affected by motor complete spinal cord injury are unable to stand, walk, or move their lower limbs voluntarily; this diagnosis normally implies severe limitations for functional recovery. We have recently shown that the appropriate selection of epidural stimulation parameters was critical to promoting full-body, weight-bearing standing with independent knee extension in four individuals with chronic clinically complete paralysis. In the current study, we examined the effects of stand training and subsequent step training with epidural stimulation on motor function for standing in the same four individuals...
October 5, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27552219/electrical-stimulation-of-low-threshold-proprioceptive-fibers-in-the-adult-rat-increases-density-of-glutamatergic-and-cholinergic-terminals-on-ankle-extensor-%C3%AE-motoneurons
#7
Olga Gajewska-Woźniak, Kamil Grycz, Julita Czarkowska-Bauch, Małgorzata Skup
The effects of stimulation of low-threshold proprioceptive afferents in the tibial nerve on two types of excitatory inputs to α-motoneurons were tested. The first input is formed by glutamatergic Ia sensory afferents contacting monosynaptically α-motoneurons. The second one is the cholinergic input originating from V0c-interneurons, located in lamina X of the spinal cord, modulating activity of α-motoneurons via C-terminals. Our aim was to clarify whether enhancement of signaling to ankle extensor α-motoneurons, via direct electrical stimulation addressed predominantly to low-threshold proprioceptive fibers in the tibial nerve of awake rats, will affect Ia glutamatergic and cholinergic innervation of α-motoneurons of lateral gastrocnemius (LG)...
2016: PloS One
https://www.readbyqxmd.com/read/27476516/recent-advances-in-spinal-cord-stimulation-for-pain-treatment
#8
Ganesan Baranidharan, John Titterington
Traditional (40-50 Hz) spinal column stimulation is an efficacious and widely accepted treatment for chronic neuropathic pain conditions. However, there are major challenges including its ineffectiveness for axial back pain, the burden of paresthesia-related discomfort and difficulties producing indisputable research. Recently, there have been the major technological innovations of high-frequency and burst stimulation. Studies have shown these to provide improved analgesia even for axial pain without the problems associated with paresthesia...
November 2016: Pain Management
https://www.readbyqxmd.com/read/27455042/new-modalities-of-neurostimulation-high-frequency-and-dorsal-root-ganglion
#9
Lance A Roy, Rathnayaka Mudiyanselage Kalpanee D Gunasingha, Richard Rauck
PURPOSE OF REVIEW: Neurostimulation is a well tolerated, cost-efficient, and effective method to treat chronic pain. Although spinal cord stimulation (SCS) has been shown to help patients, newer modalities such as burst, kilohertz-frequency, and dorsal root ganglion stimulation may provide greater pain relief, fewer paresthesias, and better outcomes. RECENT FINDINGS: Burst stimulation, programed as five-impulse burst at a frequency of 500 Hz, delivers more charge per second than conventional stimulation...
October 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27445503/a-review-of-spinal-cord-stimulation-systems-for-chronic-pain
#10
REVIEW
Paul Verrills, Chantelle Sinclair, Adele Barnard
Spinal cord stimulation (SCS) applications and technologies are fast advancing. New SCS technologies are being used increasingly in the clinical environment, but often there is a lag period between the clinical application and the publishing of high-quality evidence on safety and efficacy. Recent developments will undoubtedly expand the applicability of SCS, allowing more effective and individualized treatment for patients, and may have the potential to salvage patients who have previously failed neuromodulation...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27399458/179%C3%A2-chemogenetic-stimulation-of-the-lumbar-locomotor-network-enhances-motor-function-following-experimental-cervical-spinal-cord-injury-translational-relevance-for-a-novel-therapeutic-strategy
#11
Spyridon K Karadimas, Kajana Satkunendrarajah, Michael G Fehlings
INTRODUCTION: Cervical spinal cord injury (cSCI), the most common type of SCI, results in substantial motor impairment. No effective treatment options currently exist to restore motor function. The neural network responsible for locomotion resides within the lumbar region of the spinal cord. Interestingly, we discovered for the first time significant neural degeneration of the lumbar locomotor network during the chronic phase of cSCI. Here, we hypothesized that early chemogenetic stimulation of the lumbar glutamatergic cells may prevent degeneration of the locomotor central pattern generator and the associated motor decline after cSCI...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27374336/changing-balance-of-spinal-cord-excitability-and-nociceptive-brain-activity-in-early-human-development
#12
Caroline Hartley, Fiona Moultrie, Deniz Gursul, Amy Hoskin, Eleri Adams, Richard Rogers, Rebeccah Slater
In adults, nociceptive reflexes and behavioral responses are modulated by a network of brain regions via descending projections to the spinal dorsal horn [1]. Coordinated responses to noxious inputs manifest from a balance of descending facilitation and inhibition. In contrast, young infants display exaggerated and uncoordinated limb reflexes [2]. Our understanding of nociceptive processing in the infant brain has been advanced by the use of electrophysiological and hemodynamic imaging [3-6]. From approximately 35 weeks' gestation, nociceptive-specific patterns of brain activity emerge [7], whereas prior to this, non-specific bursts of activity occur in response to noxious, tactile, visual, and auditory stimulation [7-10]...
August 8, 2016: Current Biology: CB
https://www.readbyqxmd.com/read/27334950/relationship-of-membrane-properties-spike-burst-responses-laminar-location-and-functional-class-of-dorsal-horn-neurons-recorded-in-vitro
#13
Patrick M Dougherty, Jinghong Chen
The input-output and discharge properties of neurons are shaped by both passive and active electrophysiological membrane properties. Whole cell patch-clamp recordings in lamina I-III neurons in an isolated preparation of the whole spinal cord of juvenile rats with attached dorsal roots and dorsal root ganglia were used to further define which of these properties provides the most impactful classification strategy. A total of 95 neurons were recorded in segment L5 and were classified based on the responses to L4 dorsal root stimulation...
September 1, 2016: Journal of Neurophysiology
https://www.readbyqxmd.com/read/27302679/intraspinal-transplantation-of-subventricular-zone-derived-neural-progenitor-cells-improves-phrenic-motor-output-after-high-cervical-spinal-cord-injury
#14
M S Sandhu, H H Ross, K Z Lee, B K Ormerod, P J Reier, D D Fuller
Following spinal cord injury (SCI), intraspinal transplantation of neural progenitor cells (NPCs) harvested from the forebrain sub-ventricular zone (SVZ) can improve locomotor outcomes. Cervical SCI often results in respiratory-related impairments, and here we used an established model cervical SCI (C2 hemisection, C2Hx) to confirm the feasibility of mid-cervical transplantation of SVZ-derived NPCs and the hypothesis that that this procedure would improve spontaneous respiratory motor recovery. NPCs were isolated from the SVZ of enhanced green fluorescent protein (GFP) expressing neonatal rats, and then intraspinally delivered immediately caudal to an acute C2Hx lesion in adult non-GFP rats...
June 11, 2016: Experimental Neurology
https://www.readbyqxmd.com/read/27150431/parameters-of-spinal-cord-stimulation-and-their-role-in-electrical-charge-delivery-a-review
#15
REVIEW
Jonathan P Miller, Sam Eldabe, Eric Buchser, Lisa M Johanek, Yun Guan, Bengt Linderoth
OBJECTIVE: All spinal cord stimulation (SCS) parameters (amplitude, pulse width, frequency) influence the interaction of stimulation with the nervous system and impact the delivery of charge. Regardless of the stimulation pattern, there are certain crucial elements related to dose, and a basic fundamental knowledge of the parameters used to administer the therapy is fundamentally important. METHODS: This paper reviews basic concepts of energy delivery in neurostimulation (amplitude, pulse width, and frequency) and introduces the concept of the duty cycle and charge per sec as another way to characterize stimulation patterns...
June 2016: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/27139915/a-systematic-evaluation-of-burst-spinal-cord-stimulation-for-chronic-back-and-limb-pain
#16
REVIEW
Saiyun Hou, Kenneth Kemp, Martin Grabois
BACKGROUND: Traditional tonic spinal cord stimulation (SCS) has been approved by FDA for chronic pain of intractable back and limb pain. However, it induces paresthesia and relieves pain poorly to some extent. Recently, burst SCS has been developed for pain reduction without the mandatory paresthesia. STUDY DESIGN: A systematic review of burst SCS for chronic back and limb pain. OBJECTIVE: The objective of this systematic review is to determine the effects of burst SCS on pain relief without paresthesia for various conditions including failed back surgery syndrome, painful diabetic neuropathy, and radiculopathy...
June 2016: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/27075538/integration-of-sensory-spinal-and-volitional-descending-inputs-in-regulation-of-human-locomotion
#17
Yury Gerasimenko, Parag Gad, Dimitry Sayenko, Zach McKinney, Ruslan Gorodnichev, Aleksandr Puhov, Tatiana Moshonkina, Aleksandr Savochin, Victor Selionov, Tatiana Shigueva, Elena Tomilovskaya, Inessa Kozlovskaya, V Reggie Edgerton
We reported previously that both transcutaneous electrical spinal cord stimulation and direct pressure stimulation of the plantar surfaces of the feet can elicit rhythmic involuntary step-like movements in noninjured subjects with their legs in a gravity-neutral apparatus. The present experiments investigated the convergence of spinal and plantar pressure stimulation and voluntary effort in the activation of locomotor movements in uninjured subjects under full body weight support in a vertical position. For all conditions, leg movements were analyzed using electromyographic (EMG) recordings and optical motion capture of joint kinematics...
July 1, 2016: Journal of Neurophysiology
https://www.readbyqxmd.com/read/27059278/effect-of-burst-stimulation-evaluated-in-patients-familiar-with-spinal-cord-stimulation
#18
Marleen C Tjepkema-Cloostermans, Cecile C de Vos, Rian Wolters, Cindy Dijkstra-Scholten, Mathieu W P M Lenders
OBJECTIVE: Spinal cord stimulation (SCS) is used for treating intractable neuropathic pain. It has been suggested that burst SCS (five pulses at 500 Hz, delivered 40 times per second) suppresses neuropathic pain at least as well as conventional tonic SCS, but without evoking paraesthesia. The efficacy of paraesthesia-free high and low amplitude burst SCS for the treatment of neuropathic pain in patients who are already familiar with tonic SCS was evaluated. MATERIALS AND METHODS: Forty patients receiving conventional (30-120 Hz) tonic SCS for at least six months were included...
July 2016: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/27013936/generation-of-locomotor-like-activity-in-the-isolated-rat-spinal-cord-using-intraspinal-electrical-microstimulation-driven-by-a-digital-neuromorphic-cpg
#19
Sébastien Joucla, Matthieu Ambroise, Timothée Levi, Thierry Lafon, Philippe Chauvet, Sylvain Saïghi, Yannick Bornat, Noëlle Lewis, Sylvie Renaud, Blaise Yvert
Neural prostheses based on electrical microstimulation offer promising perspectives to restore functions following lesions of the central nervous system (CNS). They require the identification of appropriate stimulation sites and the coordination of their activation to achieve the restoration of functional activity. On the long term, a challenging perspective is to control microstimulation by artificial neural networks hybridized to the living tissue. Regarding the use of this strategy to restore locomotor activity in the spinal cord, to date, there has been no proof of principle of such hybrid approach driving intraspinal microstimulation (ISMS)...
2016: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/26962714/the-effects-of-lidocaine-on-central-respiratory-neuron-activity-and-nociceptive-related-responses-in-the-brainstem-spinal-cord-preparation-of-the-newborn-rat
#20
COMPARATIVE STUDY
Tomoharu Shakuo, Shih-Tien Lin, Hiroshi Onimaru
BACKGROUND: Lidocaine is widely used in the clinical setting as a local anesthetic and antiarrhythmic drug. Although it has been suggested that lidocaine exerts inhibitory effects on the central and peripheral neurons, there are no reports on its effects on central respiratory activity in vertebrates. In this study, we examined the effects of lidocaine on respiratory rhythm generation and nociceptive response in brainstem-spinal cord preparations from the newborn rats. METHODS: Preparations were isolated from Wistar rats (postnatal day 0-3) and superfused with artificial cerebrospinal fluid equilibrated with 95% O2 and 5% CO2, pH 7...
May 2016: Anesthesia and Analgesia
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