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Neuromodulation for pain

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https://www.readbyqxmd.com/read/28098766/single-electrode-deep-brain-stimulation-with-dual-targeting-at-dual-frequency-for-the-treatment-of-chronic-pain-a-case-series-and-review-of-the-literature
#1
REVIEW
Milo Hollingworth, Hugh P Sims-Williams, Anthony E Pickering, Neil Barua, Nikunj K Patel
Deep Brain Stimulation (DBS) has been used to target many deep brain structures for the treatment of chronic pain. The periaqueductal grey and periventricular grey (PAG/PVG) is an effective target but results are variable, sometimes short-lived or subject to tolerance. The centromedian intra-laminar parafascicular complex (CMPf) modulates medial pain pathways and CMPf DBS may address the affective aspects of pain perception. Stimulation of multiple deep brain targets may offer a strategy to optimize management of patients with complex pain symptomatology...
January 13, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28097532/medication-overuse-in-chronic-pain
#2
REVIEW
Eric S Hsu
PURPOSE OF REVIEW: Chronic pain is usually managed by various pharmacotherapies after exhausting the conservative modalities such as over-the-counter choices. The goal of this review is to investigate current state of opioids and non-opioid medication overuse that includes NSAIDs, skeletal muscle relaxants, antidepressants, membrane stabilization agents, and benzodiazepine. How to minimize medication overuse and achieve better outcome in chronic pain management? RECENT FINDINGS: Although antidepressants and membrane stabilization agents contribute to the crucial components for neuromodulation, opioids were frequently designated as a rescue remedy in chronic pain since adjunct analgesics usually do not provide instantaneous relief...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28076964/trigeminal-neuralgia-diagnosis-and-treatment
#3
Stine Maarbjerg, Giulia Di Stefano, Lars Bendtsen, Giorgio Cruccu
Introduction Trigeminal neuralgia (TN) is characterized by touch-evoked unilateral brief shock-like paroxysmal pain in one or more divisions of the trigeminal nerve. In addition to the paroxysmal pain, some patients also have continuous pain. TN is divided into classical TN (CTN) and secondary TN (STN). Etiology and pathophysiology Demyelination of primary sensory trigeminal afferents in the root entry zone is the predominant pathophysiological mechanism. Most likely, demyelination paves the way for generation of ectopic impulses and ephaptic crosstalk...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28057156/-short-term-outcome-of-sacral-neuromodulation-on-refractory-interstitial-cystitis-pelvic-pain-syndrome
#4
P Zhang, J Z Zhang, L Y Wu, H Q Niu, Y B Yang, X D Zhang
Objective: To summarize the initial experiences of applying sacral neuromodulation (SNM) for refractory interstitial cystitis/pelvic pain syndrome (IC/PPS). Methods: From January 2013 to August 2016, 26 patients with refractory IC/PPS (including 5 males and 21 females) treated with SNM were recruited in Beijing Chaoyang Hospital and Hebei Yanda Hospital in this retrospective study. The data before operation, after implantation of stage Ⅰ tined lead, and during short-term follow-up after implantation of stage Ⅱ implanted pulse generator (IPG) were compared in order to observe the improvement of relevant symptoms, and to summarize the effectiveness and safety of SNM for IC/PPS...
December 27, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28042909/the-neurostimulation-appropriateness-consensus-committee-nacc-recommendations-for-infection-prevention-and-management
#5
Timothy R Deer, David A Provenzano, Michael Hanes, Jason E Pope, Simon J Thomson, Marc A Russo, Tory McJunkin, Michael Saulino, Louis J Raso, Shivanand P Lad, Samer Narouze, Steven M Falowski, Robert M Levy, Ganesan Baranidharan, Stanley Golovac, Didier Demesmin, William O Witt, Brian Simpson, Elliot Krames, Nagy Mekhail
INTRODUCTION: The use of neurostimulation for pain has been an established therapy for many decades and is a major tool in the arsenal to treat neuropathic pain syndromes. Level I evidence has recently been presented to substantiate the therapy, but this is balanced against the risk of complications of an interventional technique. METHODS: The Neurostimulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society convened an international panel of well published and diverse physicians to examine the best practices for infection mitigation and management in patients undergoing neurostimulation...
January 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28042904/the-polyanalgesic-consensus-conference-pacc-recommendations-on-intrathecal-drug-infusion-systems-best-practices-and-guidelines
#6
REVIEW
Timothy R Deer, Jason E Pope, Salim Hayek, Anjum Bux, Eric Buchser, Sam Eldabe, Jose A De Andrés, Michael Erdek, Dennis Patin, Jay S Grider, Daniel M Doleys, Marilyn S Jacobs, Tony L Yaksh, Lawrence Poree, Mark S Wallace, Joshua Prager, Richard Rauck, Oscar DeLeon, Sudhir Diwan, Steven M Falowski, Helena M Gazelka, Philip Kim, Michael Leong, Robert M Levy, Gladstone McDowell Ii, Porter McRoberts, Ramana Naidu, Samir Narouze, Christophe Perruchoud, Steven M Rosen, William S Rosenberg, Michael Saulino, Peter Staats, Lisa J Stearns, Dean Willis, Elliot Krames, Marc Huntoon, Nagy Mekhail
INTRODUCTION: Pain treatment is best performed when a patient-centric, safety-based philosophy is used to determine an algorithmic process to guide care. Since 2007, the International Neuromodulation Society has organized a group of experts to evaluate evidence and create a Polyanalgesic Consensus Conference (PACC) to guide practice. METHODS: The current PACC update was designed to address the deficiencies and innovations emerging since the previous PACC publication of 2012...
January 2, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28034986/influence-of-sexual-hormones-on-neural-orofacial-perception
#7
Bruna Alves, Flavia Ibuki, Alyne Simões Gonçalves, Manoel Jacobsen Teixeira, Silvia Regina Dowgan Tesseroli De Siqueira
OBJECTIVE  : To investigate the trigeminal somatosensory (thermal, pain, tactile, vibratory, and electric), gustative (salty, bitter, sweet, sour), and olfactory thresholds in healthy women during the menstrual cycle and investigate any association with estradiol and progesterone levels in saliva. METHODS : We examined/tested 39 women between age 19 and 47 years and with regular menstrual cycles and no comorbidities. All women were informed about the purposes of the study, and only those who signed the informed consent were included...
December 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28027855/neuromodulation-for-chronic-pain-and-double-incontinence-in-children
#8
EDITORIAL
Alfred Peter Born
No abstract text is available yet for this article.
December 20, 2016: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28025375/intrathecal-therapy-for-cancer-related-pain
#9
REVIEW
Brian M Bruel, Allen W Burton
OBJECTIVE: The increasing incidence of cancer survivorship has shifted treatment of cancer-related pain from short-term analgesia to long-term chronic pain management. As a result, alternatives to oral analgesics, such as intrathecal therapy, may be beneficial for patients with cancer-related pain. The authors review the use of intrathecal therapy in the management of cancer-related pain. METHODS: The Medline database was searched for English-language articles that included "ziconotide" or "morphine" AND ("cancer" OR "malignant") AND "intrathecal" in title or abstract...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28017162/quadratus-lumborum-block-in-chronic-pain-after-abdominal-hernia-repair-case-report
#10
Rita Carvalho, Elena Segura, Maria do Céu Loureiro, José Pedro Assunção
BACKGROUND AND OBJECTIVES: The quadratus lumborum blockade was described by R. Blanco in its two approaches (I and II). The local anesthetic deposition in this location can provide blockade to T6-L1 dermatomes. We performed this fascia blockade guided by ultrasound for treating a chronic neuropathic pain in the abdominal wall. CASE REPORT: Male patient, 61 years old, 83kg, with a history of thrombocytopenia due to alcoholic cirrhosis, among others; had chronic pain in the abdominal wall after multiple abdominal hernia repairs in the last year and a half, with poor response to treatment with neuromodulators and opioids...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27959284/the-proposed-use-of-cervical-spinal-cord-stimulation-for-the-treatment-and-prevention-of-cognitive-decline-in-dementias-and-neurodegenerative-disorders
#11
Nestor D Tomycz
Cervical spinal cord stimulation is a well-established treatment for intractable neuropathic upper extremity pain. More than 20years ago it was demonstrated that cervical spinal cord stimulation could engender an increase in cerebral blood flow. Cerebral blood flow has been shown to be decreased in many patients with dementia and in various neurodegenerative disorders such as Alzheimer's disease and Parkinson's disease. Furthermore, there is evidence that reduced cerebral blood flow worsens neurodegenerative disease and may also predict which patients progress from mild cognitive impairment to full blown Alzheimer's disease...
November 2016: Medical Hypotheses
https://www.readbyqxmd.com/read/27958714/a-chemogenetic-receptor-that-enhances-the-magnitude-and-frequency-of-glycinergic-inhibitory-postsynaptic-currents-without-inducing-a-tonic-chloride-flux
#12
Robiul Islam, Yan Zhang, Li Xu, Pankaj Sah, Joseph W Lynch
The gene transfer-mediated expression of inhibitory ion channels in nociceptive neurons holds promise for treating intractable pain. Chemogenetics, which involves expressing constructs activated by biologically inert molecules, is of particular interest as it permits tunable neuromodulation. However, current chloride-permeable chemogenetic constructs are problematic as they mediate a tonic chloride influx which over time would deplete the chloride electrochemical gradient and reduce inhibitory efficacy. Inflammatory pain sensitization can be caused by prostaglandin E2-mediated inhibition of glycinergic inhibitory postsynaptic currents in spinal nociceptive neurons...
December 15, 2016: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/27930554/pulsed-radiofrequency-treatment-of-the-superior-hypogastric-plexus-in-an-interstitial-cystitis-patient-with-chronic-pain-and-symptoms-refractory-to-oral-and-intravesical-medications-and-bladder-hydrodistension-a-case-report
#13
Jong Hae Kim, Eugene Kim, Bong Il Kim
RATIONALE: A variety of therapeutic modalities are available for the treatment of interstitial cystitis. However, among them, the less invasive therapies are usually ineffective, whereas the invasive ones carry potential risks of serious side effects and complications. Pulsed radiofrequency (PRF) treatment of the superior hypogastric plexus may be an alternative to conventional treatments, as it provides nondestructive neuromodulation to the superior hypogastric plexus, which transmits the majority of pain signals from the pelvic viscera...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27886079/cerebellar-intermittent-theta-burst-stimulation-and-motor-control-training-in-individuals-with-cervical-dystonia
#14
Lynley V Bradnam, Michelle N McDonnell, Michael C Ridding
BACKGROUND: There is emerging evidence that cervical dystonia is a neural network disorder with the cerebellum as a key node. The cerebellum may provide a target for neuromodulation as a therapeutic intervention in cervical dystonia. OBJECTIVE: This study aimed to assess effects of intermittent theta-burst stimulation of the cerebellum on dystonia symptoms, quality of life, hand motor dexterity and cortical neurophysiology using transcranial magnetic stimulation...
November 23, 2016: Brain Sciences
https://www.readbyqxmd.com/read/27876655/dorsal-root-ganglion-stimulation-attenuates-the-bold-signal-response-to-noxious-sensory-input-in-specific-brain-regions-insights-into-a-possible-mechanism-for-analgesia
#15
Christopher P Pawela, Jeffery M Kramer, Quinn H Hogan
Targeted dorsal root ganglion (DRG) electrical stimulation (i.e. ganglionic field stimulation - GFS) is an emerging therapeutic approach to alleviate chronic pain. Here we describe blood oxygen-level dependent (BOLD) functional magnetic resonance imaging (fMRI) responses to noxious hind-limb stimulation in a rat model that replicates clinical GFS using an electrode implanted adjacent to the DRG. Acute noxious sensory stimulation in the absence of GFS caused robust BOLD fMRI response in brain regions previously associated with sensory and pain-related response, such as primary/secondary somatosensory cortex, retrosplenial granular cortex, thalamus, caudate putamen, nucleus accumbens, globus pallidus, and amygdala...
November 20, 2016: NeuroImage
https://www.readbyqxmd.com/read/27854251/nociceptive-trp-channels-sensory-detectors-and-transducers-in-multiple-pain-pathologies
#16
REVIEW
Aaron D Mickle, Andrew J Shepherd, Durga P Mohapatra
Specialized receptors belonging to the transient receptor potential (TRP) family of ligand-gated ion channels constitute the critical detectors and transducers of pain-causing stimuli. Nociceptive TRP channels are predominantly expressed by distinct subsets of sensory neurons of the peripheral nervous system. Several of these TRP channels are also expressed in neurons of the central nervous system, and in non-neuronal cells that communicate with sensory nerves. Nociceptive TRPs are activated by specific physico-chemical stimuli to provide the excitatory trigger in neurons...
November 14, 2016: Pharmaceuticals
https://www.readbyqxmd.com/read/27854104/new-practical-approaches-to-chemotherapy-induced-neuropathic-pain-prevention-assessment-and-treatment
#17
REVIEW
Neil Majithia, Charles L Loprinzi, Thomas J Smith
Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most disabling and demoralizing problems that arise for cancer survivors. When investigating symptoms of numbness, tingling, or pain in the extremities, it is critical to determine whether the problem is neuropathic, somatic, or mixed. If the diagnosis is CIPN, it is important to weigh the potential benefits and harms of possible treatment options, and to devise an evidence-based multimodality treatment program. Such programs may include mixtures of opioid and nonopioid adjunctive medications, based on evidence from CIPN trials, and also extrapolation from trials in patients with other neuropathic pain syndromes-although such extrapolating must be done with caution, since other syndromes sometimes respond to agents that CIPN does not respond to...
November 15, 2016: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/27843683/spinal-neuromodulation-as-a-novel-surgical-option-for-failed-back-surgery-syndrome-following-rhbmp-exuberant-bony-growth-in-instrumented-lumbar-fusion-a-case-report-and-literature-review
#18
Ramsis F Ghaly, Alexei Lissounov, Tatiana Tverdohleb, David Kohanchi, Kenneth D Candido, Nebojsa Nick Knezevic
BACKGROUND: Bone morphogenic protein (BMP) for instrumented lumbar fusion was approved in 2002, and since then has led to an increasing incidence of BMP-related neuropathic pain. These patients are usually resistant to conventional medical therapy and frequently undergo multiple surgical revisions without any pain relief. CASE DESCRIPTION: A 58-year-old male was referred to the author's outpatient clinic after four lumbar surgeries did not provide satisfactory pain relief...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27843360/minimal-adverse-effects-profile-following-implantation-of-periauricular-percutaneous-electrical-nerve-field-stimulators-a-retrospective-cohort-study
#19
Arthur Roberts, Alec Sithole, Marcos Sedghi, Charles A Walker, Theresa M Quinn
The periauricular percutaneous implantation of the Neuro-Stim System™ family of devices EAD, MFS, and BRIDGE is a procedure involving the use of a non-opiate, neuromodulation analgesic for relieving acute and chronic pain. It has been approved as a minimal-risk procedure by multiple governmental and institutional facilities. This retrospective report of findings will help quantify the incidence of clinically observed bleeding, localized dermatitis, and infections at the implantation sites of the electrode/needle arrays, dermatitis at the site of the generator, and patient syncope...
2016: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/27828784/peripheral-neuromodulation-for-the-treatment-of-postamputation-neuroma-pain-a-case-report
#20
Kaare Meier, Thomas F Bendtsen, Jens Christian Sørensen, Lone Nikolajsen
Neuroma pain can be severe, persistent, and treatment resistant. We present a case of a 37-year-old female amputee who suffered from severe neuroma pain, which had proved resistant to pharmacologic treatment, glycerol injections, spinal cord stimulation, radiofrequency thermocoagulation, and repeated surgical removals. After treatment with peripheral nerve stimulation, using a St. Jude Medical Octrode lead implanted percutaneously under ultrasound guidance close to her painful neuroma, her ongoing pain dramatically decreased from 8 to 3 on a numeric rating scale (0-10)...
January 15, 2017: A & A Case Reports
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