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Epidural electrical stimulation

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https://www.readbyqxmd.com/read/27881958/motor-cortex-neurostimulation-technologies-for-chronic-post-stroke-pain-implications-of-tissue-damage-on-stimulation-currents
#1
Anthony T O'Brien, Rivadavio Amorim, R Jarrett Rushmore, Uri Eden, Linda Afifi, Laura Dipietro, Timothy Wagner, Antoni Valero-Cabré
Background: Central post stroke pain (CPSP) is a highly refractory syndrome that can occur after stroke. Primary motor cortex (M1) brain stimulation using epidural brain stimulation (EBS), transcranial magnetic stimulation (TMS), and transcranial direct current stimulation (tDCS) have been explored as potential therapies for CPSP. These techniques have demonstrated variable clinical efficacy. It is hypothesized that changes in the stimulating currents that are caused by stroke-induced changes in brain tissue conductivity limit the efficacy of these techniques...
2016: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/27830790/a-brain-spine-interface-alleviating-gait-deficits-after-spinal-cord-injury-in-primates
#2
Marco Capogrosso, Tomislav Milekovic, David Borton, Fabien Wagner, Eduardo Martin Moraud, Jean-Baptiste Mignardot, Nicolas Buse, Jerome Gandar, Quentin Barraud, David Xing, Elodie Rey, Simone Duis, Yang Jianzhong, Wai Kin D Ko, Qin Li, Peter Detemple, Tim Denison, Silvestro Micera, Erwan Bezard, Jocelyne Bloch, Grégoire Courtine
Spinal cord injury disrupts the communication between the brain and the spinal circuits that orchestrate movement. To bypass the lesion, brain-computer interfaces have directly linked cortical activity to electrical stimulation of muscles, and have thus restored grasping abilities after hand paralysis. Theoretically, this strategy could also restore control over leg muscle activity for walking. However, replicating the complex sequence of individual muscle activation patterns underlying natural and adaptive locomotor movements poses formidable conceptual and technological challenges...
November 9, 2016: Nature
https://www.readbyqxmd.com/read/27798422/epidural-and-transcutaneous-spinal-electrical-stimulation-for-restoration-of-movement-after-incomplete-and-complete-spinal-cord-injury
#3
Winfried Mayr, Matthias Krenn, Milan R Dimitrijevic
PURPOSE OF REVIEW: The Purpose of this review is to outline and explain the therapeutic use of electrical spinal cord stimulation (SCS) for modification of spinal motor output. Central functional stimulation provides afferent input to posterior root neurons and is applied to improve volitional movements, posture and their endurance, control spasticity, and improve bladder function or perfusion in the lower limbs. Clinical accomplishments strongly depend on each individual's physiological state and specific methodical adaptation to that physiological state...
December 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27763875/modulation-of-respiratory-output-by-cervical-epidural-stimulation-in-the-anesthetized-mouse
#4
Ruyi Huang, Serapio M Baca, Jason W Worrell, Xingquan Liu, Yeji Seo, James C Leiter, Daniel C Lu
Respiration is produced and controlled by well-characterized brainstem nuclei, but the contributions of spinal circuits to respiratory control and modulation remain under investigation. Many respiratory studies are conducted in in vitro preparations (e.g., brainstem slice) obtained from neonatal rodents. While informative, these studies do not fully recapitulate the complex afferent and efferent neural circuits that are likely to be involved in eupnea (i.e., quiet breathing). To begin to investigate spinal contributions to respiration, we electrically stimulated the cervical spinal cord during unassisted respiration in anesthetized, intact mice...
October 7, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27701161/bioelectric-medicine-and-devices-for-the-treatment-of-spinal-cord-injury
#5
Tess Torregrosa, Ryan A Koppes
Recovery of motor control is paramount for patients living with paralysis following spinal cord injury (SCI). While a cure or regenerative intervention remains on the horizon for the treatment of SCI, a number of neuroprosthetic devices have been employed to treat and mitigate the symptoms of paralysis associated with injuries to the spinal column and associated comorbidities. The recent success of epidural stimulation to restore voluntary motor function in the lower limbs of a small cohort of patients has breathed new life into the promise of electric-based medicine...
2016: Cells, Tissues, Organs
https://www.readbyqxmd.com/read/27658771/current-experience-of-spinal-neuromodulation-in-chronic-pain-is-there-a-role-in-children-and-young-people
#6
David Pang
INTRODUCTION: Chronic pain in children has been an under-recognized problem compared to adult pain. The aim of management is to help children and their families cope with the symptoms rather than a cure. Current medical treatments to reduce pain intensity are often short lived, poorly tolerated or ineffective. RESULTS: The use of electrical stimulation to treat pain is the current basis of modern Neuromodulation at the spinal cord and has been well established as spinal cord stimulation in adult practice...
August 9, 2016: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/27589093/activation-of-cannabinoid-cb1-receptor-contributes-to-suppression-of-spinal-nociceptive-transmission-and-inhibition-of-mechanical-hypersensitivity-by-a%C3%AE-fiber-stimulation
#7
Fei Yang, Qian Xu, Bin Shu, Vinod Tiwari, Shao-Qiu He, Louis P Vera-Portocarrero, Xinzhong Dong, Bengt Linderoth, Srinivasa N Raja, Yun Wang, Yun Guan
Activation of Aβ-fibers is an intrinsic feature of spinal cord stimulation (SCS) pain therapy. Cannabinoid receptor type 1 (CB1) is important to neuronal plasticity and pain modulation, but its role in SCS-induced pain inhibition remains unclear. In this study, we showed that CB1 receptors are expressed in both excitatory and inhibitory interneurons in substantia gelatinosa (SG). Patch-clamp recording of the evoked excitatory postsynaptic currents (eEPSCs) in mice after spinal nerve ligation (SNL) showed that electrical stimulation of Aβ-fibers (Aβ-ES) using clinical SCS-like parameters (50 Hz, 0...
November 2016: Pain
https://www.readbyqxmd.com/read/27586244/neurophysiological-intraoperative-monitoring-during-an-optic-nerve-schwannoma-removal
#8
Daniel San-Juan, Manuel Escanio Cortés, Martha Tena-Suck, Adolfo Josué Orozco Garduño, Jesús Alejandro López Pizano, Jonathan Villanueva Domínguez, Maricarmen Fernández Gónzalez-Aragón, Juan Luis Gómez-Amador
This paper reports the case of a patient with optic nerve schwannoma and the first use of neurophysiological intraoperative monitoring of visual evoked potentials during the removal of such tumor with no postoperative visual damage. Schwannomas are benign neoplasms of the peripheral nervous system arising from the neural crest-derived Schwann cells, these tumors are rarely located in the optic nerve and the treatment consists on surgical removal leading to high risk of damage to the visual pathway. Case report of a thirty-year-old woman with an optic nerve schwannoma...
September 1, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27511815/ean-guidelines-on-central-neurostimulation-therapy-in-chronic-pain-conditions
#9
G Cruccu, L Garcia-Larrea, P Hansson, M Keindl, J-P Lefaucheur, W Paulus, R Taylor, V Tronnier, A Truini, N Attal
BACKGROUND AND PURPOSE: Our aim was to update previous European Federation of Neurological Societies guidelines on neurostimulation for neuropathic pain, expanding the search to new techniques and to chronic pain conditions other than neuropathic pain, and assessing the evidence with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. METHODS: A systematic review and meta-analysis of trials published between 2006 and December 2014 was conducted...
October 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/27399401/122%C3%A2-pulse-modulation-of-the-occipital-nerve-using-focused-high-intensity-ultrasound-improves-mechanical-thresholds-in-a-chronic-migraine-rat-model
#10
Ian Thomas Walling, Lucy Gee, Paul Neubauer, Lance Frith, Emery Williams, Clif Burdette, Julie G Pilitsis
INTRODUCTION: Chronic migraines (CM) afflict approximately 16.6% of adults and negatively impact quality of life. Furthermore, although some CM can be treated with steroids, occipital nerve block, radiofrequency therapy, or medical therapy, approximately 15% of patients remain refractory to treatment. We explore focused high-intensity ultrasound (HIU) as a therapy allowing for ablation or pulse modulation of the occipital nerve in a validated rodent model of CM. METHODS: Male Sprague-Dawley rats received inflammatory media via an epidural cannula over 3 weeks to induce a CM state...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27381425/neuromodulation-of-the-neural-circuits-controlling-the-lower-urinary-tract
#11
Parag N Gad, Roland R Roy, Hui Zhong, Yury P Gerasimenko, Giuliano Taccola, V Reggie Edgerton
The inability to control timely bladder emptying is one of the most serious challenges among the many functional deficits that occur after a spinal cord injury. We previously demonstrated that electrodes placed epidurally on the dorsum of the spinal cord can be used in animals and humans to recover postural and locomotor function after complete paralysis and can be used to enable voiding in spinal rats. In the present study, we examined the neuromodulation of lower urinary tract function associated with acute epidural spinal cord stimulation, locomotion, and peripheral nerve stimulation in adult rats...
July 2, 2016: Experimental Neurology
https://www.readbyqxmd.com/read/27189902/advancing-age-and-ischemia-elevate-the-electric-threshold-to-elicit-spreading-depolarization-in-the-cerebral-cortex-of-young-adult-rats
#12
Péter Hertelendy, Ákos Menyhárt, Péter Makra, Zoltán Süle, Tamás Kiss, Gergely Tóth, Orsolya Ivánkovits-Kiss, Ferenc Bari, Eszter Farkas
Spreading depolarizations of long cumulative duration have been implicated in lesion development and progression in patients with stroke and traumatic brain injury. Spreading depolarizations evolve less likely in the aged brain, but it remains to be determined at what age the susceptibility to spreading depolarizations starts to decline, especially in ischemia. Spreading depolarizations were triggered by epidural electric stimulation prior and after ischemia induction in the cortex of 7-30 weeks old anesthetized rats (n = 38)...
April 11, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27188153/sensorimotor-regulation-of-movements-novel-strategies-for-the-recovery-of-mobility
#13
Y Gerasimenko, I Kozlovskaya, V R Edgerton
A series of observations have provided important insight into properties of the spinal as well as supraspinal circuitries that control posture and movement. We have demonstrated that spinal rats can regain full weight-bearing standing and stepping over a range of speeds and directions with the aid of electrically enabling motor control (eEmc), pharmacological modulation (fEmc), and training. Also, we have reported that voluntary control movements of individual joints and limbs can be regained after complete paralysis in humans...
January 2016: Fiziologiia Cheloveka
https://www.readbyqxmd.com/read/27168496/safety-assessment-of-epidural-wire-electrodes-for-cough-production-in-a-chronic-pig-model-of-spinal-cord-injury
#14
Krzysztof E Kowalski, Tomasz Kowalski, Anthony F DiMarco
BACKGROUND: It is our hypothesis that high intensity spinal cord stimulation (SCS) to restore an effective cough mechanism using wire leads, will result in significant activation of target neurons without tissue injury or electrode corrosion. METHODS: Adult mini-pigs underwent chronic spinal cord compression, followed by implantation of parallel wire leads on the dorsal epidural surface of the spinal cord, with stimulation contacts at the T9 and T12, and control electrode contacts at the T2 and T5 levels...
August 1, 2016: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/27148019/brain-stimulation-therapy-for-central-post-stroke-pain-from-a-perspective-of-interhemispheric-neural-network-remodeling
#15
Takashi Morishita, Tooru Inoue
Central post-stroke pain (CPSP) is a debilitating, severe disorder affecting patient quality of life. Since CPSP is refractory to medication, various treatment modalities have been tried with marginal results. Following the first report of epidural motor cortex (M1) stimulation (MCS) for CPSP, many researchers have investigated the mechanisms of electrical stimulation of the M1. CPSP is currently considered to be a maladapted network reorganization problem following stroke, and recent studies have revealed that the activities of the impaired hemisphere after stroke may be inhibited by the contralesional hemisphere...
2016: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/27111644/response-patterns-to-the-electric-stimulation-of-epidural-catheters-in-pregnant-women-a-randomized-controlled-trial-of-uniport-versus-multiport-catheters
#16
Ruchira Patel, Cristian Arzola, Vitali Petrounevitch, Mrinalini Balki, Kristi Downey, Ban C H Tsui, Jose C A Carvalho
BACKGROUND: The transcatheter electric stimulation test (Tsui test) can be performed at the bedside to confirm the correct placement of a wire-reinforced epidural catheter within the epidural space. The most commonly observed motor response with a uniport epidural catheter placed in the lumbar area is the unilateral contraction of the lower limbs. Wire-reinforced multiport catheters have recently been introduced into clinical practice; however, the characteristics of the Tsui test with such catheters are unknown...
October 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26986188/the-effect-of-transcutaneous-electrical-nerve-stimulation-on-post-thoracotomy-pain
#17
Sevilay Erden, Sevilay Senol Celik
BACKGROUND: Pain guidelines suggest transcutaneous electrical nerve stimulation (TENS) as a reliable analgesic method in postoperative pain. OBJECTIVES: This study was conducted as a randomized controlled study to determine the effect of TENS on postoperative pain and analgesic consumption in patients who have undergone posterolateral thoracotomy (PLT). DESIGN: The study was conducted in the Thoracic Surgery Clinic of a university hospital with 40 patients (test group: 20, control group: 20) and its power was 99%...
October 2015: Contemporary Nurse
https://www.readbyqxmd.com/read/26915679/sonographic-evaluation-of-epidural-and-intrathecal-injections-in-cats
#18
Pablo E Otero, Natali Verdier, Andrea S Zaccagnini, Santiago E Fuensalida, Matias Sclocco, Diego A Portela, Samanta Waxman
OBJECTIVES: To describe the ultrasonographic anatomy of the caudal lumbar spine in cats and to detect ultrasound (US) signs associated with epidural or intrathecal injection. STUDY DESIGN: Prospective, clinical study. ANIMALS: Twenty-six client-owned cats. METHODS: Transverse (position 1) and parasagittal (position 2) two-dimensional US scanning was performed over the caudal lumbar spine in all cats. Midline distances between the identified structures were measured...
February 25, 2016: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/26853304/mechanisms-underlying-the-neuromodulation-of-spinal-circuits-for-correcting-gait-and-balance-deficits-after-spinal-cord-injury
#19
Eduardo Martin Moraud, Marco Capogrosso, Emanuele Formento, Nikolaus Wenger, Jack DiGiovanna, Grégoire Courtine, Silvestro Micera
Epidural electrical stimulation of lumbar segments facilitates standing and walking in animal models and humans with spinal cord injury. However, the mechanisms through which this neuromodulation therapy engages spinal circuits remain enigmatic. Using computer simulations and behavioral experiments, we provide evidence that epidural electrical stimulation interacts with muscle spindle feedback circuits to modulate muscle activity during locomotion. Hypothesis-driven strategies emerging from simulations steered the design of stimulation protocols that adjust bilateral hindlimb kinematics throughout gait execution...
February 17, 2016: Neuron
https://www.readbyqxmd.com/read/26792233/unique-spatiotemporal-neuromodulation-of-the-lumbosacral-circuitry-shapes-locomotor-success-after-spinal-cord-injury
#20
Prithvi K Shah, Shakthi Sureddi, Monzurul Alam, Hui Zhong, Roland R Roy, V Reggie Edgerton, Yury Gerasimenko
Spinal cord epidural stimulation has resulted in the initiation of voluntary leg movements and improvement in postural, bladder, and sexual function. However, one of the limitations in reaching the full potential of epidural stimulation for therapeutic purposes in humans has been the identification of optimal stimulation configurations that can neuromodulate the spinal cord for stepping. In the present work, we investigated the mechanisms underlying the specificity of interaction between the rostral and caudal spinal cord circuitries in enabling locomotion in spinal rats (n = 10) by epidural spinal cord stimulation...
September 15, 2016: Journal of Neurotrauma
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