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Neuromodulation for pain

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https://www.readbyqxmd.com/read/29763654/obturator-neuromodulation-with-laparoscopic-placement-of-an-obturator-lead-for-the-treatment-of-intractable-opioid-dependent-chronic-pelvic-pain-due-to-obturator-neuralgia
#1
Richard P Marvel
Chronic pelvic pain(CPP) is a common condition in women that can have a devastating effect on quality of life. Some of the most severe forms of CPP are related to peripheral nerve injuries causing persistent neuropathic pain. This is a case of a young woman with severe opioid dependent chronic pelvic and right groin pain due to obturator neuralgia. She had failed a multitude of treatments including multiple medications, manual physical therapy, nerve blocks, surgical neurolysis and spinal cord stimulation without significant benefit...
May 12, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29746857/women-undergoing-third-line-overactive-bladder-treatment-demonstrate-elevated-thermal-temporal-summation
#2
W Stuart Reynolds, Casey Kowalik, Joshua Cohn, Melissa Kaufman, Alan Wein, Roger Dmochowski, Stephen Bruehl
PURPOSE: To determine if women with overactive bladder (OAB) requiring 3rd line therapy demonstrate greater central sensitization, indexed by temporal summation to heat pain stimuli, than those with OAB. MATERIALS AND METHODS: We recruited 39 adult women with OAB from the Urology clinic who were planning to undergo interventional therapy for medication refractory OAB with either onabotulinumtoxinA bladder injection or sacral neuromodulation and 55 women with OAB, either newly seen in our Urology clinic or responding to advertisements for study participation...
May 7, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29719246/scaling-up-cortical-control-inhibits-pain
#3
Jahrane Dale, Haocheng Zhou, Qiaosheng Zhang, Erik Martinez, Sile Hu, Kevin Liu, Louise Urien, Zhe Chen, Jing Wang
Acute pain evokes protective neural and behavioral responses. Chronic pain, however, disrupts normal nociceptive processing. The prefrontal cortex (PFC) is known to exert top-down regulation of sensory inputs; unfortunately, how individual PFC neurons respond to an acute pain signal is not well characterized. We found that neurons in the prelimbic region of the PFC increased firing rates of the neurons after noxious stimulations in free-moving rats. Chronic pain, however, suppressed both basal spontaneous and pain-evoked firing rates...
May 1, 2018: Cell Reports
https://www.readbyqxmd.com/read/29713421/failed-back-surgery-syndrome-a-review-article
#4
REVIEW
James R Daniell, Orso L Osti
Postsurgical spine syndrome is becoming an increasingly common challenge for clinicians who deal with spinal disorders owing to the expanding indications for spinal surgery and the aging world population. A multidisciplinary approach is most appropriate for patients who are unlikely to benefit from further formal surgical intervention. Anticonvulsant medications are effective in managing neuropathic pain after surgery, whereas opioids are rarely beneficial. Neuromodulation via a surgically implanted dorsal column neurostimulator is gaining popularity owing to its substantial superiority over conventional medical management and/or further surgical intervention...
April 2018: Asian Spine Journal
https://www.readbyqxmd.com/read/29706482/pain-in-pancreatic-ductal-adenocarcinoma-a-multidisciplinary-international-guideline-for-optimized-management
#5
REVIEW
Asbjørn M Drewes, Claudia M Campbell, Güralp O Ceyhan, Myriam Delhaye, Pramod K Garg, Harry van Goor, Berta Laquente, Bart Morlion, Søren S Olesen, Vikesh K Singh, Per Sjøgren, Eva Szigethy, John A Windsor, Marina G Salvetti, Rupjyoti Talukdar
Abdominal pain is an important symptom in most patients with pancreatic ductal adenocarcinoma (PDAC). Adequate control of pain is often unsatisfactory due to limited treatment options and significant variation in local practice, emphasizing the need for a multidisciplinary approach. This review contends that improvement in the management of PDAC pain will result from a synthesis of best practice and evidence around the world in a multidisciplinary way. To improve clinical utility and evaluation, the evidence was rated according to the GRADE guidelines by a group of international experts...
April 22, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29622698/value-of-supportive-care-pharmacogenomics-in-oncology-practice
#6
REVIEW
Jai N Patel, Lauren A Wiebe, Henry M Dunnenberger, Howard L McLeod
Genomic medicine provides opportunities to personalize cancer therapy for an individual patient. Although novel targeted therapies prolong survival, most patients with cancer continue to suffer from burdensome symptoms including pain, depression, neuropathy, nausea and vomiting, and infections, which significantly impair quality of life. Suboptimal management of these symptoms can negatively affect response to cancer treatment and overall prognosis. The effect of genetic variation on drug response-otherwise known as pharmacogenomics-is well documented and directly influences an individual patient's response to antiemetics, opioids, neuromodulators, antidepressants, antifungals, and more...
April 5, 2018: Oncologist
https://www.readbyqxmd.com/read/29621012/spinal-cord-neuromodulation-therapy-for-levofloxacin-reinduced-complex-regional-pain-syndrome-and-neurotoxicity-a-case-report
#7
David Hao, Geza Kiss, William Grubb, Shaul Cohen, Danielle Levin, Ashraf Sakr
Fluoroquinolones are a class of popular outpatient antimicrobial agents with a wide spectrum of therapeutic indications for respiratory and genitourinary infections. Though the most common side effects are gastrointestinal, fluoroquinolones have been increasingly associated with neurotoxicity including peripheral neuropathy and seizures. We present here a case of a 43-year-old woman with previously resolved type I complex regional pain syndrome (CRPS) who presented with symptoms of CRPS and neurotoxicity in the setting of levofloxacin administration...
March 31, 2018: A&A practice
https://www.readbyqxmd.com/read/29608807/long-term-effect-of-peripheral-nerve-field-stimulation-as-add-on-therapy-to-spinal-cord-stimulation-to-treat-low-back-pain-in-failed-back-surgery-syndrome-patients-a-12-month-follow-up-of-a-randomized-controlled-study
#8
Eric-Jan J A A van Gorp, Onno Teernstra, Hans J Aukes, Tanja Hamm-Faber, Katja Bürger, Jan Willem Kallewaard, Geert Spincemaille, Johannes W L C Schapendonk, Leon Vonhögen, Ewald Bronkhorst, Kris C P Vissers
OBJECTIVE: Different approaches in neuromodulation have been used to treat chronic low back pain in failed back surgery syndrome (FBSS) patients. We previously randomized 52 FBSS patients to be treated with spinal cord stimulation (SCS) and additional peripheral nerve field stimulation (PNFS) or SCS alone. At three months, we found a significant reduction of back pain in the PNFS-SCS group compared to the SCS group. In the subsequent open phase part of the study, all patients received optimal SCS and PNFS simultaneously...
April 2, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29608229/prospective-randomized-sham-control-double-blind-crossover-trial-of-subthreshold-spinal-cord-stimulation-at-various-kilohertz-frequencies-in-subjects-suffering-from-failed-back-surgery-syndrome-scs-frequency-study
#9
Adnan Al-Kaisy, Stefano Palmisani, David Pang, Karen Sanderson, Samuel Wesley, Ye Tan, Sheryl McCammon, Andrea Trescott
INTRODUCTION: The increasing use of high frequency paresthesia-free spinal cord stimulation has been associated with improved outcomes in the therapy of neuropathic pain. What is unknown is the effect of varying frequency on pain relief and the placebo effect. MATERIALS AND METHODS: This is a prospective, randomized, sham-controlled double blind crossover study. Subjects with predominantly axial low back pain undergoing spinal cord stimulation therapy for failed back surgery syndrome were randomized to sham, 1200 Hz, 3030 Hz, and 5882 Hz with a four-phase crossover design over 12 weeks...
April 2, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29600889/transcranial-direct-current-stimulation-in-the-modulation-of-neuropathic-pain-a-systematic-review
#10
Mírian Celly Medeiros Miranda David, Alexa Alves de Moraes, Maíra Lopes da Costa, Carlúcia Ithamar Fernandes Franco
Objective To investigate the neuromodulating effect of Transcranial Direct Current Stimulation (tDCS) on Neuropathic Pain (NP). Method A systematic review of articles published in the past five years in MEDLINE, LILACS, Cochrane, Scopus, ScienceDirect, and PEDro. The search was carried out from February to May 2017 using the keywords: neuropathic pain, neuralgia, nerve pain, central pain, peripheral nerve pain, tDCS. The selected studies were full articles written in Portuguese, English, or Spanish with at least one control group, and no less than one pre- or post-intervention variable, with the exclusion of case studies or case series, animal model studies, and studies with combined therapy...
March 30, 2018: Neurological Research
https://www.readbyqxmd.com/read/29582185/neuromodulation-for-chronic-pelvic-pain
#11
REVIEW
Justina Tam, Charles Loeb, Daniel Grajower, Jason Kim, Steven Weissbart
PURPOSE OF REVIEW: Chronic pelvic pain is a heterogeneous condition that often requires multiple physician visits and various treatments prior to achieving an acceptable management strategy. Neuromodulation has been used to treat chronic pelvic pain that has failed other therapies. RECENT FINDINGS: Numerous modalities of neuromodulation have been used to alleviate chronic pelvic pain with promising results. Numerous modalities of neuromodulation have demonstrated efficacy in the management of pelvic pain...
March 26, 2018: Current Urology Reports
https://www.readbyqxmd.com/read/29575331/retrospective-case-series-on-the-treatment-of-painful-diabetic-peripheral-neuropathy-with-dorsal-root-ganglion-stimulation
#12
Sam Eldabe, Anthony Espinet, Anders Wahlstedt, Porhan Kang, Liong Liem, Nikunj K Patel, Jan Vesper, Alicia Kimber, William Cusack, Jeffery Kramer
BACKGROUND: The dorsal root ganglion (DRG) has been identified as an important neural structure in the development and maintenance of chronic pain. We present a retrospective case series of patients with refractory painful diabetic peripheral neuropathy (PDPN) that underwent electrical stimulation of the DRG and report on changes in their overall perceived pain and complication rates. METHODS: Ten diabetic males (mean age 65.2 [SD 8.8] years) with painful symptoms of the lower limbs were enrolled and trialed with up to four quadripolar percutaneous DRG stimulation leads between L2 and L5 spinal levels...
March 25, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29570127/successful-treatment-of-paradoxical-puborectalis-contraction-and-intractable-anorectal-pain-with-sacral-neuromodulation
#13
Ted M Roth
BACKGROUND: Paradoxical puborectalis contraction (PPC) is a syndrome of obstructed defecation associated with a cluster of complaints including rectal pain, incomplete evacuatory sensation, prolonged repetitive straining with bowel movements, and the need for digital manipulation. Traditional treatment has yielded mixed results. CASE: We present a case of PPC successfully treated with staged sacral neuromodulation and review her diagnostic features, medical regimen, and prior unsuccessful interventions tried...
March 21, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29566284/clinical-effect-of-c2-peripheral-nerve-field-stimulation-using-electroacupuncture-for-primary-headache
#14
Sumire Ishiyama, Yasushi Shibata, Satoshi Ayuzawa, Akira Matsushita, Akira Matsumura
OBJECTIVE: We applied C2 peripheral nerve field stimulation using electroacupuncture (EA-C2-PNfS) for primary headache, and investigated its clinical effectiveness. MATERIALS AND METHODS: Fifty-four primary headache patients (10 men, 44 women) with a mean age of 48.6 ± 15.0 years underwent EA-C2-PNfS for three months. We used questionnaires to assess outcomes; pain intensity (11-point numerical rating scale [NRS]), quality of daily life (Headache Impact Test [HIT-6]), depression (Self-Rating Depression Scale [SDS])...
March 22, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29565946/anatomy-pathophysiology-and-interventional-therapies-for-chronic-pelvic-pain-a-review
#15
Corey W Hunter, Brad Stovall, Grant Chen, Jonathan Carlson, Robert Levy
BACKGROUND: Chronic pelvic pain (CPP) represents a group of poorly understood disorders that are often refractory to conventional treatment. Referral to pain management typically occurs later in the continuum of care; as such, many of the injections and nerve blocks commonly prescribed for such patients are potentially limited in efficacy. While neuromodulation is conventionally considered the next algorithmic step in the treatment of chronic pain after injections fail, there is a common perception that neuromodulation is largely ineffective for CPP conditions...
March 2018: Pain Physician
https://www.readbyqxmd.com/read/29551556/what-is-the-best-treatment-option-for-coexisting-pelvic-floor-dysfunctions
#16
Manuela Tutolo, Enrico Ammirati, Frank Van der Aa
Although both intravesical onabotulinumtoxinA injections and sacral neuromodulation could be offered in cases of bladder pain syndrome and overactive bladder syndrome, there is still no scientific agreement on the best option after failure of standard therapies.
December 2017: European Urology Focus
https://www.readbyqxmd.com/read/29530711/mapping-and-neuromodulation-of-lower-urinary-tract-function-using-spinal-cord-stimulation-in-female-rats
#17
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...
July 2018: Experimental Neurology
https://www.readbyqxmd.com/read/29497328/managing-cluster-headache-with-sphenopalatine-ganglion-stimulation-a-review
#18
REVIEW
Denys Fontaine, Serena Santucci, Michel Lanteri-Minet
Cluster headache (CH) is a primary headache and considered as one of the worst pains known to man. The sphenopalatine ganglion (SPG) plays a pivotal role in cranial autonomic symptoms associated with pain. Lesioning procedures involving the SPG and experimental acute SPG stimulation have shown some degree of efficacy with regard to CH. A neuromodulation device, chronically implanted in the pterygopalatine fossa, has been specifically designed for acute on-demand SPG stimulation. In a pilot placebo-controlled study in 28 patients suffering from refractory chronic CH, alleviation of pain was achieved in 67...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29493566/cluster-headache
#19
REVIEW
Arne May, Todd J Schwedt, Delphine Magis, Patricia Pozo-Rosich, Stefan Evers, Shuu-Jiun Wang
Cluster headache is an excruciating, strictly one-sided pain syndrome with attacks that last between 15 minutes and 180 minutes and that are accompanied by marked ipsilateral cranial autonomic symptoms, such as lacrimation and conjunctival injection. The pain is so severe that female patients describe each attack as worse than childbirth. The past decade has seen remarkable progress in the understanding of the pathophysiological background of cluster headache and has implicated the brain, particularly the hypothalamus, as the generator of both the pain and the autonomic symptoms...
March 1, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29485036/the-evolving-clinical-picture-of-chronic-prostatitis-chronic-pelvic-pain-syndrome-cp-cpps-a-look-at-1310-patients-over-16-years
#20
R Christopher Doiron, Dean Tripp, Victoria Tolls, J Curtis Nickel
INTRODUCTION: Two decades of increasing understanding of etio-pathogenesis and clinical phenotyping produces an impression the clinical face of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is changing. We sought to retrospectively analyze trends in CP/CPPS patients presenting to our clinic for evaluation over a 16-year period. METHODS: Patients with CP/CPPS presenting to a tertiary clinic were evaluated prospectively from 1998-2014 with chronic prostatitis symptom index (CPSI) and UPOINT categorization...
February 23, 2018: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
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