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Epidural stimulation

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https://www.readbyqxmd.com/read/29089866/rapid-identification-of-cortical-motor-areas-in-rodents-by-high-frequency-automatic-cortical-stimulation-and-novel-motor-threshold-algorithm
#1
Mitsuaki Takemi, Elisa Castagnola, Alberto Ansaldo, Davide Ricci, Luciano Fadiga, Miki Taoka, Atsushi Iriki, Junichi Ushiba
Cortical stimulation mapping is a valuable tool to test the functional organization of the motor cortex in both basic neurophysiology (e.g., elucidating the process of motor plasticity) and clinical practice (e.g., before resecting brain tumors involving the motor cortex). However, compilation of motor maps based on the motor threshold (MT) requires a large number of cortical stimulations and is therefore time consuming. Shortening the time for mapping may reduce stress on the subjects and unveil short-term plasticity mechanisms...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29081513/localization-of-the-primary-sites-of-involvement-in-the-spinal-sensory-and-motor-pathways-for-multilevel-mri-abnormalities-in-degenerative-cervical-myelopathy
#2
Nobuaki Tadokoro, Toshikazu Tani, Kazunobu Kida, Katsuhito Kiyasu, Yusuke Kasai, Masashi Kumon, Ryuichi Takemasa, Masahiko Ikeuchi
STUDY DESIGN: Exploratory clinical study. OBJECTIVES: To localize the sites of conduction block in the spinal sensory and motor pathways for minimizing the level of surgical intervention despite MRI evidence of compression at several levels in degenerative cervical myelopathy (DCM). SETTING: Kochi Medical School Hospital, Japan. METHODS: We analyzed 83 DCM patients (69 ± 12 years) who underwent serial intervertebral recording of both ascending (A-SCEPs) and descending spinal cord-evoked potentials (D-SCEPs) after epidural and transcranial stimulation, respectively, during surgery before decompression procedures...
October 30, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29075183/the-role-of-functional-neuroanatomy-of-the-lumbar-spinal-cord-in-effect-of-epidural-stimulation
#3
Carlos A Cuellar, Aldo A Mendez, Riazul Islam, Jonathan S Calvert, Peter J Grahn, Bruce Knudsen, Tuan Pham, Kendall H Lee, Igor A Lavrov
In this study, the neuroanatomy of the swine lumbar spinal cord, particularly the spatial orientation of dorsal roots was correlated to the anatomical landmarks of the lumbar spine and to the magnitude of motor evoked potentials during epidural electrical stimulation (EES). We found that the proximity of the stimulating electrode to the dorsal roots entry zone across spinal segments was a critical factor to evoke higher peak-to-peak motor responses. Positioning the electrode close to the dorsal roots produced a significantly higher impact on motor evoked responses than rostro-caudal shift of electrode from segment to segment...
2017: Frontiers in Neuroanatomy
https://www.readbyqxmd.com/read/29074997/motor-recovery-after-activity-based-training-with-spinal-cord-epidural-stimulation-in-a-chronic-motor-complete-paraplegic
#4
Enrico Rejc, Claudia A Angeli, Darryn Atkinson, Susan J Harkema
The prognosis for recovery of motor function in motor complete spinal cord injured (SCI) individuals is poor. Our research team has demonstrated that lumbosacral spinal cord epidural stimulation (scES) and activity-based training can progressively promote the recovery of volitional leg movements and standing in individuals with chronic clinically complete SCI. However, scES was required to perform these motor tasks. Herein, we show the progressive recovery of voluntary leg movement and standing without scES in an individual with chronic, motor complete SCI throughout 3...
October 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29060065/a-convex-shaped-pdms-parylene-hybrid-multichannel-ecog-electrode-array
#5
Woo-Ram Lee, Changkyun Im, Chin Su Koh, Jun-Min Kim, Hyung-Cheul Shin, Jong-Mo Seo
Long-term electrode implant is a challenge for successful brain-computer interfaces (BCIs). It is well known that electrocorticography (ECoG) using flexible planar electrodes is more suitable for long-term implants than intracortical neural recordings using penetrative electrodes. In this study, we propose a convex-shaped, PDMS-parylene hybrid multi-electrode array for long-term stable ECoG recording on the brain or the spinal cord. The electrode array consists of 10 gold recording sites which show impedance values between 50 and 70 kOhm at 1 kHz with a diameter of 100 μm...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29026048/spinal-cord-stimulation-for-chronic-non-cancer-pain-a-review-of-current-evidence-and-practice
#6
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
https://www.readbyqxmd.com/read/29020054/a-novel-approach-for-automatic-visualization-and-activation-detection-of-evoked-potentials-induced-by-epidural-spinal-cord-stimulation-in-individuals-with-spinal-cord-injury
#7
Samineh Mesbah, Claudia A Angeli, Robert S Keynton, Ayman El-Baz, Susan J Harkema
Voluntary movements and the standing of spinal cord injured patients have been facilitated using lumbosacral spinal cord epidural stimulation (scES). Identifying the appropriate stimulation parameters (intensity, frequency and anode/cathode assignment) is an arduous task and requires extensive mapping of the spinal cord using evoked potentials. Effective visualization and detection of muscle evoked potentials induced by scES from the recorded electromyography (EMG) signals is critical to identify the optimal configurations and the effects of specific scES parameters on muscle activation...
2017: PloS One
https://www.readbyqxmd.com/read/28966573/a-chronically-implantable-bidirectional-neural-interface-for-non-human-primates
#8
Misako Komatsu, Eriko Sugano, Hiroshi Tomita, Naotaka Fujii
Optogenetics has potential applications in the study of epilepsy and neuroprostheses, and for studies on neural circuit dynamics. However, to achieve translation to clinical usage, optogenetic interfaces that are capable of chronic stimulation and monitoring with minimal brain trauma are required. We aimed to develop a chronically implantable device for photostimulation of the brain of non-human primates. We used a micro-light-emitting diode (LED) array with a flexible polyimide film. The array was combined with a whole-cortex electrocorticographic (ECoG) electrode array for simultaneous photostimulation and recording...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28964613/comparison-of-electrical-and-ultrasound-neurostimulation-in-rat-motor-cortex
#9
Daniel W Gulick, Tao Li, Jeffrey A Kleim, Bruce C Towe
Ultrasound (US) is known to non-invasively stimulate and modulate brain function; however, the mechanism of action is poorly understood. This study tested US stimulation of rat motor cortex (100 W/cm(2), 200 kHz) in combination with epidural cortical stimulation. US directly evoked hindlimb movement. This response occurred even with short US bursts (3 ms) and had short latency (10 ms) and long refractory (3 s) periods. Unexpectedly, the epidural cortical stimulation hindlimb response was not altered during the 3-s refractory period of the US hindlimb response...
September 27, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28943040/treatment-of-musculo-skeletal-pain-in-haemophilia
#10
REVIEW
E Carlos Rodriguez-Merchan
Musculo-skeletal pain treatment is inadequate in many haemophilic patients. Analgesics are used only by 36% of adult patients. FVIII/FIX intravenous infusion is mainly used to lessen pain, followed in frequency by usage of NSAIDS (primarily COX-2 inhibitors). In about 30% of patients, pain continues after infusion of F VIII/IX. In acute haemarthroses pain treatment must continue until total disappearance (checked by ultrasonography) and include haematologic treatment, short-term rest of the involved joint, cryotherapy, joint aspiration and analgesic medication (paracetamol in mild pain, metamizole for more intense pain, and in a few precise patients, soft opioids such as codeine or tramadol)...
September 19, 2017: Blood Reviews
https://www.readbyqxmd.com/read/28937422/placement-of-stimulating-epidural-catheter-for-a-patient-with-large-scapular-sarcoma-a-case-report
#11
James D Turner, Sean W Dobson, Robert S Weller, Christopher M Lack, Daryl S Henshaw
We report the use of continuous electrical stimulation to assist with the preoperative placement of a thoracic epidural which was used to provide postoperative analgesia in a patient undergoing excision of a large scapular sarcoma. The size of the sarcoma and the surrounding area required to maintain a sterile surgical field necessitated that the epidural catheter be inserted several vertebral interspaces caudal to the level of desired catheter tip termination. The use of electrical stimulation allowed for sequential intercostal muscle stimulation during threading, which enabled the placement of the catheter tip at the appropriate spinal level to optimize analgesia...
September 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28936608/the-effect-of-an-increased-pulse-width-on-the-pattern-of-motor-response-unilateral-versus-bilateral-during-the-tsui-test-in-labouring-parturients-a-randomized-crossover-trial
#12
Paul Zakus, Ricardo Bittencourt, Kristi Downey, Ban C H Tsui, Jose C A Carvalho
BACKGROUND AND OBJECTIVES: The typical response to the Tsui test performed via an epidural catheter placed in the lumbar area is the unilateral motor response of the lower limbs. Studies show that longer pulse widths can stimulate peripheral nerves at a lower threshold current from a farther distance. Therefore, we designed a study to test the hypothesis that epidural catheter stimulation with a 1.0-msec pulse width would increase the incidence of bilateral motor response in parturients when compared with stimulation with a 0...
September 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28895256/relevant-anatomy-morphology-and-implantation-techniques-of-the-dorsal-root-ganglia-at-the-lumbar-levels
#13
Tim Vancamp, Robert M Levy, Isaac Peña, Antonio Pajuelo
OBJECTIVES: While dorsal root ganglion (DRG) stimulation has been available in Europe and Australia for the past five years and in the United States for the past year, there are no published details concerning the optimal procedures for DRG lead implantation. MATERIALS AND METHODS: We describe several techniques that can be applied to implant cylindrical leads over the DRG, highlighting some tips and tricks according to our experiences. Focus is mainly shifted toward implantations in the lumbar area...
October 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28893697/incidence-of-postoperative-hematomas-requiring-surgical-treatment-in-neurosurgery-a-retrospective-observational-study
#14
Kadri Lillemäe, Johanna Järviö, Marja Kaarina Silvasti-Lundell, Jussi Antinheimo, Juha Hernesniemi, Tomi Tapio Niemi
OBJECTIVE: We aimed to characterize the occurrence of postoperative hematoma (POH) after neurosurgery overall and according to procedure type, and describe the prevalence of possible confounders. METHODS: Patient data between 2010 and 2012 at the Department of Neurosurgery in Helsinki University Hospital were retrospectively analyzed. Data search was performed according to the type of surgery including craniotomies; shunt procedures, spine surgery and spinal cord stimulators (SCS) implantation...
September 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28874986/neuropathic-pain-related-with-spinal-disorders-a-systematic-review
#15
REVIEW
Kwang-Sup Song, Jae Hwan Cho, Jae-Young Hong, Jae Hyup Lee, Hyun Kang, Dae-Woong Ham, Hyun-Jun Ryu
Systematic literature review. To review the evidence from high-quality studies regarding the treatment of neuropathic pain originating specifically from spinal disorders. In general, treatment guidelines for neuropathic pain cover all its various causes, including medical disease, peripheral neuropathy, and cancer. However, the natural history of neuropathic pain originating from spinal disorders may differ from that of the pain originating from other causes or lesions. An expert research librarian used terms related to neuropathic pain and spinal disorders, disc herniation, stenosis, and spinal cord injury to search in MEDLINE, Embase, and Cochrane CENTRAL for primary research from January 2000 to October 2015...
August 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28874984/neuropathic-pain-after-spinal-surgery
#16
REVIEW
Jae Hwan Cho, Jae Hyup Lee, Kwang-Sup Song, Jae-Young Hong
Neuropathic pain after spinal surgery, the so-called failed back surgery syndrome (FBSS), is a frequently observed troublesome disease entity. Although medications may be effective to some degree, many patients continue experiencing intolerable pain and functional disability. Only gabapentin has been proven effective in patients with FBSS. No relevant studies regarding manipulation or physiotherapy for FBSS have been published. Spinal cord stimulation (SCS) has been widely investigated as a treatment option for chronic neuropathic pain, including FBSS...
August 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28860857/preventing-nausea-and-vomiting-in-women-undergoing-regional-anesthesia-for-cesarean-section-challenges-and-solutions
#17
REVIEW
Yvonne Jelting, Christian Klein, Thomas Harlander, Leopold Eberhart, Norbert Roewer, Peter Kranke
BACKGROUND: Intraoperative nausea and vomiting (IONV) or postoperative nausea and vomiting (PONV) affecting women undergoing regional anesthesia for cesarean section is an important clinical problem since these techniques are used widely. There are burdens of literature about IONV/PONV and several in parturient and cesarean. However, it needs more attention. The underlying mechanisms of IONV and PONV in the obstetrical setting mainly include hypotension due to sympathicolysis during neuraxial anesthesia, bradycardia owing to an increased vagal tone, the visceral stimulation via the surgical procedure and intravenously administered opioids...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28827823/comparison-of-efficacy-of-continuous-epidural-block-and-pulsed-radiofrequency-to-the-dorsal-root-ganglion-for-management-of-pain-persisting-beyond-the-acute-phase-of-herpes-zoster
#18
COMPARATIVE STUDY
Eung Don Kim, Young In Lee, Hue Jung Park
BACKGROUND: There is little evidence regarding the effectiveness of intervention methods in the treatment of zoster-related pain (ZAP) after the acute phase of zoster. Generally, if ZAP remains after more than 180 days from its onset, the likelihood of pain reduction is very low; this condition is considered as a "well established" post-herpetic neuralgia (PHN). Although the clinical efficacy of intrathecal steroid injection and spinal cord stimulation (SCS) for ZAP management has been reported, these interventions are not widely used due to inherent disadvantages...
2017: PloS One
https://www.readbyqxmd.com/read/28808583/successful-spinal-cord-stimulation-for-neuropathic-below-level-spinal-cord-injury-pain-following-complete-paraplegia-a-case-report
#19
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
https://www.readbyqxmd.com/read/28803750/motor-cortex-and-spinal-cord-neuromodulation-promote-corticospinal-tract-axonal-outgrowth-and-motor-recovery-after-cervical-contusion-spinal-cord-injury
#20
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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