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Burst spinal cord stimulation.

Huiyi H Chang, Jih-Chao Yeh, Ronaldo M Ichiyama, Larissa V Rodriguez, Leif A Havton
Spinal cord epidural stimulation (SCS) represents a form of neuromodulation for the management of spasticity and pain. This technology has recently emerged as a new approach for potentially augmenting locomotion and voiding function in humans and rodents after spinal cord injury. However, the effect of SCS on micturition has not been studied extensively. Here, SCS was first applied as a direct stimulus onto individual segmental levels of the lumbar spinal cord in rats to map evoked external urethral sphincter (EUS) electromyography activity and SCS-induced voiding contractions...
March 9, 2018: Experimental Neurology
Marie-Amélie Farreny, Eric Agius, Sophie Bel-Vialar, Nathalie Escalas, Nagham Khouri-Farah, Chadi Soukkarieh, Cathy Danesin, Fabienne Pituello, Philippe Cochard, Cathy Soula
BACKGROUND: Most oligodendrocytes of the spinal cord originate from ventral progenitor cells of the pMN domain, characterized by expression of the transcription factor Olig2. A minority of oligodendrocytes is also recognized to emerge from dorsal progenitors during fetal development. The prevailing view is that generation of ventral oligodendrocytes depends on Sonic hedgehog (Shh) while dorsal oligodendrocytes develop under the influence of Fibroblast Growth Factors (FGFs). RESULTS: Using the well-established model of the chicken embryo, we show that ventral spinal progenitor cells activate FGF signaling at the onset of oligodendrocyte precursor cell (OPC) generation...
March 8, 2018: Neural Development
Mark W Urban, Biswarup Ghosh, Laura R Strojny, Cole G Block, Sara M Blazejewski, Megan C Wright, George M Smith, Angelo C Lepore
Damage to respiratory neural circuitry and consequent loss of diaphragm function is a major cause of morbidity and mortality in individuals suffering from traumatic cervical spinal cord injury (SCI). Repair of CNS axons after SCI remains a therapeutic challenge, despite current efforts. SCI disrupts inspiratory signals originating in the rostral ventral respiratory group (rVRG) of the medulla from their phrenic motor neuron (PhMN) targets, resulting in loss of diaphragm function. Using a rat model of cervical hemisection SCI, we aimed to restore rVRG-PhMN-diaphragm circuitry by stimulating regeneration of injured rVRG axons via targeted induction of Rheb (ras homolog enriched in brain), a signaling molecule that regulates neuronal-intrinsic axon growth potential...
February 14, 2018: Experimental Neurology
Samuel Jimenez, Laura Mordillo-Mateos, Michele Dileone, Michela Campolo, Carmen Carrasco-Lopez, Fabricia Moitinho-Ferreira, Tomas Gallego-Izquierdo, Hartwig R Siebner, Josep Valls-Solé, Juan Aguilar, Antonio Oliviero
Spinal plasticity is thought to contribute to sensorimotor recovery of limb function in several neurological disorders and can be experimentally induced in animals and humans using different stimulation protocols. In healthy individuals, electrical continuous Theta Burst Stimulation (TBS) of the median nerve has been shown to change spinal motoneuron excitability in the cervical spinal cord as indexed by a change in mean H-reflex amplitude in the flexor carpi radialis muscle. It is unknown whether continuous TBS of a peripheral nerve can also shift motoneuron excitability in the lower limb...
2018: PloS One
Krishnan Chakravarthy, Alexander R Kent, Adil Raza, Fang Xing, Thomas M Kinfe
BACKGROUND: Burst spinal cord stimulation (SCS) technology uses a novel waveform that consists of closely packed high-frequency electrical impulses followed by a quiescent period. Within the growing field of neuromodulation, burst stimulation is unique in that it mimics the natural burst firing of the nervous system, in particular the thalamo-cingulate rhythmicity, resulting in modulation of the affective and attentional components of pain processing (e.g., medial thalamic pathways). STUDY DESIGN: A review of preclinical and clinical studies regarding burst SCS for various chronic pain states...
February 12, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Hao Li, Karen Waterhouse, Aleksander Vitali
No abstract text is available yet for this article.
November 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
James T Buchanan
The spinal cord has been well established as the site of generation of the locomotor rhythm in vertebrates, but studies have suggested that the caudal hindbrain in larval fish and amphibians can also generate locomotor rhythms. Here, we investigated whether the caudal hindbrain of the adult lamprey (Petromyzon marinus and Ichthyomyzon unicuspis) has the ability to generate the swimming rhythm. The hindbrain-spinal cord transition zone of the lamprey contains a bilateral column of somatic motoneurons that project via the spino-occipital (S-O) nerves to several muscles of the head...
January 24, 2018: Journal of Neurophysiology
Tommaso Bocci, Giuliano De Carolis, Mery Paroli, Davide Barloscio, Laura Parenti, Lara Tollapi, Massimiliano Valeriani, Ferdinando Sartucci
RATIONALE: Spinal cord stimulation (SCS) is an effective option for neuropathic pain treatment. New technological developments, as high-frequency (HF) and theta burst stimulation (TBS), have shown promising results, although putative mechanisms of action still remain debated. METHODS: thirty patients with lower back pain were enrolled and underwent LF, HF, and TBS. Laser evoked potentials (LEPs) were recorded by using a Nd:YAG laser. Amplitudes and latencies of the main two components (N1, N2/P2) were compared among different experimental sessions...
January 4, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Shaheen Ahmed, Thomas Yearwood, Dirk De Ridder, Sven Vanneste
Paresthesia-free spinal cord stimulation (SCS) techniques, such as burst and high-frequency (HF) SCS, have been developed and demonstrated to be successful for treating chronic pain, albeit via different mechanisms of action. The goal of this review is to discuss the mechanisms of action for pain suppression at both the cellular and systems levels for burst and HF SCS. In addition, we also discuss the neuromodulation devices that mimic these paradigms. Areas covered: The authors performed a literature review to unravel the mechanisms of action for burst and HF SCS coupled with booklets and user manuals from neuromodulation companies to understand the programmable parameters and operating ranges...
January 2018: Expert Review of Medical Devices
J A Messina, Alison St Paul, Sarah Hargis, Wengora E Thompson, Andrew D McClellan
The contribution of left-right reciprocal coupling between spinal locomotor networks to the generation of locomotor activity was tested in adult lampreys. Muscle recordings were made from normal animals as well as from experimental animals with rostral midline (ML) spinal lesions (~13%→35% body length, BL), before and after spinal transections (T) at 35% BL. Importantly, in the present study actual locomotor movements and muscle burst activity, as well as other motor activity, were initiated in whole animals by descending brain-spinal pathways in response to sensory stimulation of the anterior head...
2017: Frontiers in Neural Circuits
Roxanna Rasekhi, Danielle Babb, Chane Price
The prevalence of neuromuscular diseases and peripheral neuropathies in veterans exposed to Agent Orange (AO) is particularly high. Pharmacologic management has not been effective for these patients. Burst therapy spinal cord stimulation (SCS), recently approved for use in the United States, has had demonstrable success in both Europe and Australia. We present a patient with AO-induced peripheral neuropathy who was successfully treated with burst SCS. To our knowledge, this is the first report describing the use of burst SCS for treatment of peripheral neuropathy related to AO exposure...
November 27, 2017: A & A Case Reports
Koen P V Meuwissen, Jianwen Wendy Gu, Tianhe C Zhang, Elbert A J Joosten
OBJECTIVE: Various spinal cord stimulation (SCS) modes are used in the treatment of chronic neuropathic pain disorders. Conventional (Con) and Burst-SCS are hypothesized to exert analgesic effects through different stimulation-induced mechanisms. Preclinical electrophysiological findings suggest that stimulation intensity is correlated with the effectiveness of Burst-SCS. Therefore, we aimed to investigate the relation between amplitude (charge per second) and behavioral effects in a rat model of chronic neuropathic pain, for both Conventional Spinal Cord Stimulation (Con-SCS) and biphasic Burst-SCS...
January 2018: Neuromodulation: Journal of the International Neuromodulation Society
Sajjad Muhammad, Shafqat R Chaudhry, Thomas L Yearwood, Joachim K Krauss, Thomas M Kinfe
OBJECTIVES: In our previous study, anti-inflammatory IL-10 serum levels were significantly elevated after burst spinal cord stimulation (SCS) in back pain patients and correlated with pain intensity. This current study extended cytokine analysis including metabolic-associated adipokine/cytokine serum assessment in chronic back pain patients with co-existing metabolic disorders such as diabetes, hypertension, and cardiovascular diseases. METHODS: At baseline and after three months of burst SCS treatment, leptin (LP), adiponectin (AN), and ghrelin (GH) were recorded in non-/pre-obese chronic back pain patients with co-existing metabolic disorders and compared to age-/gender-matched healthy controls (HC)...
October 24, 2017: Neuromodulation: Journal of the International Neuromodulation Society
Jared M Cregg, Kevin A Chu, Lydia E Hager, Rachel S J Maggard, Daimen R Stoltz, Michaela Edmond, Warren J Alilain, Polyxeni Philippidou, Lynn T Landmesser, Jerry Silver
Spinal cord injury (SCI) above cervical level 4 disrupts descending axons from the medulla that innervate phrenic motor neurons, causing permanent paralysis of the diaphragm. Using an ex vivo preparation in neonatal mice, we have identified an excitatory spinal network that can direct phrenic motor bursting in the absence of medullary input. After complete cervical SCI, blockade of fast inhibitory synaptic transmission caused spontaneous, bilaterally coordinated phrenic bursting. Here, spinal cord glutamatergic neurons were both sufficient and necessary for the induction of phrenic bursts...
October 17, 2017: Cell Reports
S Sc Wong, C W Chan, C W Cheung
Spinal cord stimulation provides analgesia through electrical stimulation of the dorsal column of the spinal cord via electrode leads placed into the epidural space. In traditional tonic stimulation, a painful sensation is replaced with paraesthesia. Spinal cord stimulation is effective in reducing neuropathic pain, enhancing function, and improving quality of life in different chronic pain conditions. Currently, there is most evidence to support its use for failed back surgery syndrome when multidisciplinary conventional management is unsuccessful...
October 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Sergio H Duenas-Jimenez, Luis Castillo Hernandez, Braniff de la Torre Valdovinos, Gerardo Mendizabal Ruiz, Judith M Duenas Jimenez, Viviana Ramirez Abundis, Irene Guadalupe Aguilar Garcia
In brain cortex-ablated cats (BCAC), hind limb motoneurons activity patterns were studied during fictive locomotion (FL) or fictive scratching (FS) induced by pinna stimulation. In order to study motoneurons excitability: heteronymous monosynaptic reflex (HeMR), intracellular recording, and individual Ia afferent fiber antidromic activity (AA) were analyzed. The intraspinal cord microinjections of serotonin or glutamic acid effects were made to study their influence in FL or FS During FS, HeMR amplitude in extensor and bifunctional motoneurons increased prior to or during the respective electroneurogram (ENG)...
September 2017: Physiological Reports
Timothy Deer, Konstantin V Slavin, Kasra Amirdelfan, Richard B North, Allen W Burton, Thomas L Yearwood, Ed Tavel, Peter Staats, Steven Falowski, Jason Pope, Rafael Justiz, Alain Y Fabi, Alexander Taghva, Richard Paicius, Timothy Houden, Derron Wilson
OBJECTIVE: The purpose of the multicenter, randomized, unblinded, crossover success using neuromodulation with BURST (SUNBURST) study was to determine the safety and efficacy of a device delivering both traditional tonic stimulation and burst stimulation to patients with chronic pain of the trunk and/or limbs. METHODS: Following a successful tonic trial, 100 subjects were randomized to receive one stimulation mode for the first 12 weeks, and then the other stimulation mode for the next 12 weeks...
September 29, 2017: Neuromodulation: Journal of the International Neuromodulation Society
Jijun Xu, Aijun Liu, Jianguo Cheng
PURPOSE OF REVIEW: To update the recent development of spinal cord stimulation (SCS) technology in the management of chronic pain. RECENT FINDINGS: Efficacy of SCS therapy has been significantly improved by the recent development of high frequency (HF-10 kHz) stimulation, burst stimulation, and dorsal root ganglion (DRG) stimulation. A few latest SCS modalities are in clinical trial. New approaches to guide lead placement and advances in surgical lead are introduced...
December 2017: Current Opinion in Anaesthesiology
Tim A Reck, Gunther Landmann
INTRODUCTION: Neuropathic pain is common in patients with spinal cord injury (SCI) and often difficult to treat. We report a case where epidural spinal cord stimulation (SCS) below the level of injury has been successfully applied in a patient with a complete spinal cord lesion. CASE PRESENTATION: A 53-year-old female presented with neuropathic below-level SCI pain of both lower legs and feet due to complete SCI below T5. Time and pain duration since injury was 2 years...
2017: Spinal Cord Series and Cases
N Zareen, M Shinozaki, D Ryan, H Alexander, A Amer, D Q Truong, N Khadka, A Sarkar, S Naeem, M Bikson, J H Martin
Cervical injuries are the most common form of SCI. In this study, we used a neuromodulatory approach to promote skilled movement recovery and repair of the corticospinal tract (CST) after a moderately severe C4 midline contusion in adult rats. We used bilateral epidural intermittent theta burst (iTBS) electrical stimulation of motor cortex to promote CST axonal sprouting and cathodal trans-spinal direct current stimulation (tsDCS) to enhance spinal cord activation to motor cortex stimulation after injury. We used Finite Element Method (FEM) modeling to direct tsDCS to the cervical enlargement...
November 2017: Experimental Neurology
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