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peripheral nerve field stimulation

Brian A Simpson, Ravindra Nannapaneni
BACKGROUND: With its relative simplicity and safety, peripheral nerve field stimulation (PNFS; PENS) is contributing to the re-emergence of peripheral nerve stimulation as an effective therapy for neuropathic pain (NPP). CASE PRESENTATION: A 70-year-old woman had developed severe, medically refractory NPP unilaterally in the scalp and face 20 years earlier, following a maxillofacial surgical procedure. PNFS gave substantial relief of the pain and allodynia and was repeated successfully on a further 25 occasions over the subsequent five years...
October 14, 2016: Neuromodulation: Journal of the International Neuromodulation Society
Krishnan Chakravarthy, Andrew Nava, Paul J Christo, Kayode Williams
Peripheral nerve stimulation (PNS) for the treatment of chronic pain has become an increasingly important field in the arena of neuromodulation, given the ongoing advances in electrical neuromodulation technology since 1999 permitting minimally invasive approaches using an percutaneous approach as opposed to implantable systems. Our review aims to provide clinicians with the recent advances and studies in the field, with specific emphasis on clinical data and indications that have been accumulated over the last several years...
November 2016: Current Pain and Headache Reports
Anthony Heagerty
There is now a considerable body of evidence to suggest that the fat cells that surround blood vessels (perivascular adipose tissue, PVAT) can influence profoundly arterial tone by releasing vasodilator adipokines which can act locally in a paracrine fashion. In healthy lean individuals the primary vasodilator released appears to be adiponectin and there is a complex interation between autonomic nerve firing in PVAT and the release of nitric oxide from adipocytes and an increased bioavailability of adiponectin...
September 2016: Journal of Hypertension
Ahmed S El-Azab, Steven W Siegel
The field of Sacral Neuromodulation is continually evolving and still in its infancy. Common dilemmas experienced with this therapy will be discussed in this article, including ways to avoid and manage them. The focus will be on test evaluations performed with either peripheral nerve evaluation (PNE) or staged procedure, the clinical effectiveness and safety of unilateral versus bilateral test stimulation for both the PNE and staged procedures, and best methods to determine the success of the trial phase. We will also discuss how to deal with the problem of declining efficacy of the device over time...
November 2016: Current Urology Reports
Shushovan Chakrabortty, Sanjeev Kumar, Deepak Gupta, Sruthi Rudraraju
As many as 62% low back pain patients can have sacroiliac joint (SIJ) pain. There is limited (to poor) evidence in regards to long-term pain relief with therapeutic intra-articular injections and/or conventional (heat or pulsed) radiofrequency ablations (RFAs) for SIJ pain. We report our pain-clinic experience with peripheral nerve field stimulation (PNFS) for two patients of intractable SIJ pain. They had reported absence of long-term pain relief (pain relief >50% for at least 2 weeks postinjection and at least 3 months post-RFA) with SIJ injections and SIJ RFAs...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Elliot Smith, Fabio Freschi, Maurizio Repetto, Stuart Crozier
PURPOSE: Gradient strength and speed are limited by peripheral nerve stimulation (PNS) thresholds. The coil array method allows the gradient field to be moved across the imaging area. This can help reduce PNS and provide faster imaging for image-guided therapy systems such as the magnetic resonance imaging-guided linear accelerator (MRI-linac). THEORY: The coil array is designed such that many coils produce magnetic fields, which combine to give the desired gradient profile...
September 8, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Matthew J Snyder, Lawrence M Gibbs, Tammy J Lindsay
Painful diabetic peripheral neuropathy occurs in approximately 25% of patients with diabetes mellitus who are treated in the office setting and significantly affects quality of life. It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses proximally from the feet and hands. Clinicians should carefully consider the patient's goals and functional status and potential adverse effects of medication when choosing a treatment for painful diabetic peripheral neuropathy...
August 1, 2016: American Family Physician
Kazuhiro Sugawara, Hideaki Onishi, Koya Yamashiro, Shinichi Kotan, Sho Kojima, Shota Miyaguchi, Atsuhiro Tsubaki, Hikari Kirimoto, Hiroyuki Tamaki, Hiroshi Shirozu, Shigeki Kameyama
Afferent somatosensory information is modulated before the afferent input arrives at the primary somatosensory cortex during voluntary movement. The aim of the present study was to clarify the effect of muscular contraction strength on somatosensory evoked fields (SEFs) during voluntary movement. In addition, we examined the differences in gating between innervated and non-innervated muscle during contraction. We investigated the changes in gating effect by muscular contraction strength and innervated and non-innervated muscles in human using 306-channel magnetoencephalography...
July 19, 2016: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Mark Lowrie, Laurent Garosi
This review focuses on important new findings in the field of involuntary movements (IM) in dogs and illustrates the importance of developing a clear classification tool for diagnosing tremor and twitches. Developments over the last decade have changed our understanding of IM and highlight several caveats in the current tremor classification. Given the ambiguous association between tremor phenomenology and tremor aetiology, a more cautious definition of tremors based on clinical assessment is required. An algorithm for the characterisation of tremors is presented herein...
August 2016: Veterinary Journal
Bruce Mitchell, Paul Verrills, David Vivian, Neels DuToit, Adele Barnard, Chantelle Sinclair
OBJECTIVE: Relative to the number of patients suffering chronic lumbar and cervical pain, fewer patients suffer persistent thoracic pain. Consequently there is less literature, with smaller sample sizes, reporting treatment of this cohort. Here, we assess peripheral nerve field stimulation (PNfS) as a potential treatment for chronic thoracic pain. MATERIALS AND METHODS: This study included 20 consecutive chronic thoracic pain sufferers that responded successfully to PNfS trial...
July 4, 2016: Neuromodulation: Journal of the International Neuromodulation Society
Martin Jakobs, Andreas Unterberg, Rolf-Detlef Treede, Sigrid Schuh-Hofer, Rezvan Ahmadi
BACKGROUND: Neurosurgical pain management of drug-resistant trigeminal neuralgia (TN) is highly challenging. Microvascular decompression is a first-line neurosurgical approach for classical TN with neurovascular conflict, but can show clinical relapse despite proper decompression. Second-line destructive techniques like radiofrequency thermocoagulation have become reluctantly used due to their potential for irreversible side effects. Subcutaneous peripheral nerve field stimulation (sPNFS) is a minimally invasive neuromodulatory technique which has been shown to be effective for chronic localised pain conditions...
September 2016: Acta Neurochirurgica
Ken Steffen Frahm, Kristian Hennings, Louis Vera-Portocarrero, Paul W Wacnik, Carsten Dahl Mørch
BACKGROUND: Peripheral nerve field stimulation (PNFS) is a potential treatment for chronic low-back pain. Pain relief using PNFS is dependent on activation of non-nociceptive Aβ-fibers. However, PNFS may also activate muscles, causing twitches and discomfort. In this study, we developed a mathematical model, to investigate the activation of sensory and motor nerves, as well as direct muscle fiber activation. METHODS: The extracellular field was estimated using a finite element model based on the geometry of CT scanned lumbar vertebrae...
August 2016: Neuromodulation: Journal of the International Neuromodulation Society
Andrew Shaw, Mayur Sharma, Zion Zibly, Daniel Ikeda, Milind Deogaonkar
OBJECTIVE: Ilioinguinal neuralgia (IG) and genitofemoral (GF) neuralgia following inguinal hernia repair is a chronic and debilitating neuropathic condition. Recently, peripheral nerve stimulation has become an effective and minimally invasive option for the treatment of refractory pain. Here we present a retrospective case series of six patients who underwent placement of peripheral nerve stimulation electrodes using various techniques for treatment of refractory post-intervention inguinal region pain...
June 27, 2016: British Journal of Neurosurgery
Young-Hwan Kim, Ji-Hyun Jeong, Duck-Sun Ahn, Seungsoo Chung
Agmatine, a putative endogenous ligand of imidazoline receptors, suppresses cardiovascular function by inhibiting peripheral sympathetic tone. However, the molecular identity of imidazoline receptor subtypes and its cellular mechanism underlying the agmatine-induced sympathetic suppression remains unknown. Meanwhile, N-type Ca(2+) channels are important for the regulation of NA release in the peripheral sympathetic nervous system. Therefore, it is possible that agmatine suppresses NA release in peripheral sympathetic nerve terminals by inhibiting Ca(2+) influx through N-type Ca(2+) channels...
August 26, 2016: Biochemical and Biophysical Research Communications
M Ahlborg, C Kaethner, T Knopp, P Szwargulski, T M Buzug
The imaging technology magnetic particle imaging allows the detection of magnetic material, in particular superparamagnetic nanoparticles, by remagnetization of the material via magnetic fields. The application is aimed at medical imaging where the particles are applied as tracer directly into the blood stream. Medical safety considerations such as peripheral nerve stimulation limit the maximal amplitude of the magnetic fields and in turn the field of view size. To handle this constraint the concept of patches was introduced, which allows a shift of a field of view to different positions in order to enlarge the imaging area...
June 7, 2016: Physics in Medicine and Biology
Gernot Schmid, Rene Hirtl
The reference levels and maximum permissible exposure values for magnetic fields that are currently used have been derived from basic restrictions under the assumption of upright standing body models in a standard posture, i.e. with arms laterally down and without contact with metallic objects. Moreover, if anatomical modelling of the body was used at all, the skin was represented as a single homogeneous tissue layer. In the present paper we addressed the possible impacts of posture and skin modelling in scenarios of exposure to a 50 Hz uniform magnetic field on the in situ electric field strength in peripheral tissues, which must be limited in order to avoid peripheral nerve stimulation...
June 21, 2016: Physics in Medicine and Biology
Jun Motogi, Yukiya Sugiyama, Ilkka Laakso, Akimasa Hirata, Koji Inui, Manabu Tamura, Yoshihiro Muragaki
The in situ electric field in the peripheral nerve of the skin is investigated to discuss the selective stimulation of nerve fibres. Coaxial planar electrodes with and without intra-epidermal needle tip were considered as electrodes of a stimulator. From electromagnetic analysis, the tip depth of the intra-epidermal electrode should be larger than the thickness of the stratum corneum, the electrical conductivity of which is much lower than the remaining tissue. The effect of different radii of the outer ring electrode on the in situ electric field is marginal...
June 21, 2016: Physics in Medicine and Biology
Xuefeng Qu, Jiaqing Yan, Xiaoli Li, Peixun Zhang, Xianzeng Liu
PURPOSE: Traditionally, the topography of somatosensory evoked potentials (SEPs) is generated based on amplitude and latency. However, this operation focuses on the physical morphology and field potential-power, so it suffers from difficulties in performing identification in an objective manner. In this study, measurement of the synchronization of SEPs is proposed as a method to explore brain functional networks as well as the plasticity after peripheral nerve injury. METHOD: SEPs elicited by unilateral sciatic nerve stimulation in twelve adult male Sprague-Dawley (SD) rats in the normal group were compared with SEPs evoked after unilateral sciatic nerve hemisection in four peripheral nerve injured SD rats...
2016: Frontiers in Computational Neuroscience
Shichao Jiang, Hao Zhang, Min Fang, Yuqui Zhang, Ning Lu, Qingguang Zhu, Yanbin Cheng, Jian Ai, Nan Zhou, Jianhua Li, Lei Fang, Fei Yao
Previous clinical trials have suggested that the Chinese Tuina massage may exert transient analgesic effects. However, further investigation regarding the underlying mechanism has been hindered by the lack of a suitable animal model of pain. The present study established a rat model of hind leg pain by injecting 5.8% hypertonic saline solution (HSS) into the left gastrocnemius muscle. The effects of various Tuina massages on the pain thresholds of the rats were then measured. In addition, the effects of ipsilateral and contralateral Tuina massages on C-fiber-evoked field potentials following electrical stimulation of the left sciatic nerve were determined...
April 2016: Experimental and Therapeutic Medicine
Vincenzo Levi, Giuseppe Messina, Angelo Franzini, Luca Zanin, Nicolo Castelli, Ivano Dones
BACKGROUND: Treatment-related chronic neuropathic pain represents a major and increasing cause of discomfort in cancer survivors. Unfortunately, in approximately 10%-15% of cases, pain is scarcely relieved by opioids and common painkillers. Thus, alternative measures to manage pain have recently been adopted in these patients. CASE DESCRIPTION: We report the case of a laryngeal cancer survivor who developed an intractable bilateral mandibular radiation-induced neuropathic pain syndrome...
July 2016: World Neurosurgery
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