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Neuromodulation for pain

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https://www.readbyqxmd.com/read/28726232/-frequent-episodic-migraine-and-calcitonin-gene-related-peptide-influence-of-treatment-with-topiramate-and-zonisamide-on-levels-of-the-peptide
#1
D A Garcia-Estevez, M Pardo-Parrado, S Silvarrey-Rodriguez
INTRODUCTION: The pathophysiology of pain in migraine is related to the activation of the trigeminovascular system by releasing vasoactive neuropeptides, the most important of which is calcitonin gene-related peptide (CGRP), which causes a neurogenic inflammation in the leptomeningeal vessels. AIM: To study whether CGRP is increased in frequent episodic migraine and whether preventive treatment with topiramate or zonisamide modifies its levels. SUBJECTS AND METHODS: We studied 28 patients with episodic migraine with or without aura, in accordance with the International Headache Society criteria, with a frequency of 4-14 days/month...
August 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28712018/laparoscopic-implantation-of-electrodes-for-bilateral-neuromodulation-of-the-pudendal-nerves-and-s3-nerve-roots-for-treating-pelvic-pain-and-voiding-dysfunction
#2
Adrienne L K Li, Renato Marques, Acary Oliveira, Laise Veloso, Manoel J B C Girão, Nucelio Lemos
INTRODUCTION AND HYPOTHESIS: The objective of this video is to describe the technique for laparoscopic implantation of electrodes for bilateral neuromodulation of S3 and pudendal nerves. We report a successful case of a 48-year-old woman with spina bifida occulta referred with a 14-year history of intense acyclic pelvic pain, urinary hesitancy, and intermittent flow refractory to various conservative measures. METHODS: The procedure began with the removal of two previously placed InterStims...
July 15, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28708674/chemotherapy-induced-peripheral-neuropathy-a-review-of-recent-findings
#3
Peggy Y Kim, Carrie E Johnson
PURPOSE OF REVIEW: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, frequently chronic condition characterized by pain and decreased function. Given the growing number of cancer survivors and an increasing recognition of opioid therapy limitations, there is a need for critical analysis of the literature in directing an informed and thoughtful approach for the management of painful CIPN. RECENT FINDINGS: A PubMed search for 'chemotherapy-induced peripheral neuropathy AND pain' identifies 259 publications between 1 January 2016 and 31 March 2017...
July 13, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28699685/pocket-pain-and-neuromodulation-negligible-or-neglected
#4
Sofie Dietvorst, Thomas Decramer, Robin Lemmens, Bart Morlion, Bart Nuttin, Tom Theys
OBJECTIVES: Pain encountered at the site of the implantable pulse generator (IPG) after invasive neuromodulation is a well-known and important complication. The reported incidence of implant site pain is variable, ranging between 0.4 and 35%. Implant site pain has never been systematically studied and no treatment guidelines are available. MATERIAL AND METHODS: We performed an observational study (study registration number mp05728) on the incidence and the determining factors of implant site pain, the subjective rating of intensity by sending questionnaires (n = 554) to our cohort of neuromodulation patients with IPGs...
July 12, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28681660/strategies-for-replacing-non-invasive-brain-stimulation-sessions-recommendations-for-designing-neurostimulation-clinical-trials
#5
Aurore Thibaut, Anthony Terrence O'Brien, Felipe Fregni
Despite the potential impact of missed visits on the outcomes of neuromodulation treatments, it is not clear how this issue has been addressed in clinical trials. Given this gap in the literature, we reviewed articles on non-invasive brain stimulation in participants with depression or chronic pain, and investigated how missed visits were handled. Areas covered: We performed a search on PUBMED/MEDLINE using the keywords: "tDCS", "transcranial direct current stimulation", "transcranial magnetic stimulation¨, "depression", and "pain"...
July 6, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28677993/the-pathophysiology-of-episodic-cluster-headache-insights-from-recent-neuroimaging-research
#6
Fu-Chi Yang, Kun-Hsien Chou, Chen-Yuan Kuo, Yung-Yang Lin, Ching-Po Lin, Shuu-Jiun Wang
Background Cluster headache is a disorder characterized by intermittent, severe unilateral head pain accompanied by cranial autonomic symptoms. Most cases of CH are episodic, manifesting as "in-bout" periods of frequent headache separated by month-to-year-long "out-of-bout" periods of remission. Previous imaging studies have implicated the hypothalamus and pain matrix in the pathogenesis of episodic CH. However, the pathophysiology driving the transition between in- and out-of-bout periods remains unclear. Methods The present study provides a narrative review of previous neuroimaging studies on the pathophysiology of episodic CH, addressing alterations in brain structures, metabolism, and structural and functional connectivity occurring between bout periods...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28676368/interventional-management-for-pelvic-pain
#7
REVIEW
Ameet S Nagpal, Erika L Moody
Interventional procedures can be applied for diagnostic evaluation and treatment of the patient with pelvic pain, often once more conservative measures have failed to provide relief. This article reviews interventional management strategies for pelvic pain. We review superior and inferior hypogastric plexus blocks, ganglion impar blocks, transversus abdominis plane blocks, ilioinguinal, iliohypogastric and genitofemoral blocks, pudendal nerve blocks, and selective nerve root blocks. Additionally, we discuss trigger point injections, sacroiliac joint injections, and neuromodulation approaches...
August 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28676344/crispr-epigenome-editing-of-akap150-in-drg-neurons-abolishes-degenerative-ivd-induced-neuronal-activation
#8
Joshua D Stover, Niloofar Farhang, Kristofer C Berrett, Jason Gertz, Brandon Lawrence, Robby D Bowles
Back pain is a major contributor to disability and has significant socioeconomic impacts worldwide. The degenerative intervertebral disc (IVD) has been hypothesized to contribute to back pain, but a better understanding of the interactions between the degenerative IVD and nociceptive neurons innervating the disc and treatment strategies that directly target these interactions is needed to improve our understanding and treatment of back pain. We investigated degenerative IVD-induced changes to dorsal root ganglion (DRG) neuron activity and utilized CRISPR epigenome editing as a neuromodulation strategy...
July 1, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/28674829/-neuromodulation-using-matrix-stimulation-a-treatment-for-acute-pain
#9
M Mücke, H Schulze, L Radbruch, M Marinova, H Cuhls, D Kravchenko, R Conrad, R Rolke
BACKGROUND: There is currently a lack of studies that evaluate the effects of matrix electrode neuromodulation on acute pain. In this prospective and randomized cross-over study, we investigated the efficacy of 4 Hz-matrix stimulation on venipuncture-induced pain in 30 healthy subjects. METHODS: We compared two conditions of neurostimulation: in EC1 (experimental condition 1), we performed venipuncture during stimulation, with 2.5 min of prestimulation with 600 stimuli; in EC2 (experimental condition 2), the length of stimulation was 5 min, at 1200 stimuli, with subsequent venipuncture...
July 3, 2017: Der Schmerz
https://www.readbyqxmd.com/read/28657994/pudendal-neuromodulation-as-a-treatment-for-persistent-genital-arousal-disorder-a-case-series
#10
Natalie Gaines, Brian D Odom, Kim A Killinger, Kenneth M Peters
BACKGROUND: Persistent genital arousal disorder (PGAD) is a rare life-altering condition characterized by unwanted, uncomfortable genital sensations or spontaneous orgasms without physical or emotional stimulation. Its etiology remains unclear, and a variety of treatments have been attempted with incomplete resolution. We propose that chronic pudendal neuromodulation (CPN) may be a useful treatment for PGAD symptoms. METHODS: A retrospective chart review was performed for women older than 18 years with a diagnosis of PGAD that had staged neuromodulation with placement of a tined lead at the pudendal nerve...
June 27, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28644192/vulvodynia-younger-age-and-combined-therapies-associate-with-significant-reduction-in-self-reported-pain
#11
Anu P Aalto, Silja Vuoristo, Heidi Tuomaala, Riikka J Niemi, Synnöve M Staff, Johanna U Mäenpää
OBJECTIVES: Eight percent of women have vulvodynia (VD), a chronic pain disorder with unknown etiology. The aim of our study was to assess the efficacy of given VD treatments measured by numerical rating scale (NRS) for pain and patients' quality of life. MATERIALS AND METHODS: Study material consisted of a retrospective VD patient cohort (N = 70). Data were collected by postal questionnaires and review of the medical records. RESULTS: We report here a statistically significant reduction in NRS only with combination of therapies (median NRS before treatments 8 vs median NRS 4 after treatments, p < ...
July 2017: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/28638296/ultrasound-guided-percutaneous-cervical-and-upper-thoracic-sympathetic-chain-neuromodulation-for-upper-extremity-complex-regional-pain-syndrome
#12
Samer Narouze, Dmitri Souzdalnitski
BACKGROUND: Complex regional pain syndrome (CRPS) comprises a group of conditions characterized by severe, debilitating pain that is disproportionate to any inciting event and is not distributed in a specific nerve distribution or dermatome. CASE REPORT: A 42-year-old female with a 2-year history of right upper extremity CRPS type I refractory to conventional management underwent an ultrasound-guided and fluoroscopy confirmed percutaneous peripheral nerve stimulation trial with a lead extending from the C6 to the T3 level to cover the cervical and upper thoracic sympathetic chain...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28632962/a-novel-minimally-invasive-wireless-technology-for-neuromodulation-via-percutaneous-intercostal-nerve-stimulation-pns-for-post-herpetic-neuralgia-a-case-report-with-short-term-follow-up
#13
Bart Billet, Roel Wynendaele, Niek E Vanquathem
BACKGROUND: Peripheral nerve stimulation (PNS) of primary afferent neurons provides control of localized chronic pain. This technique applies permanent electrical stimulation at the target area via a minimally invasive, subcutaneous placement of an electrode. OBJECTIVE: To assess analgesic effects of a minimally invasive wireless neuromodulation in the treatment of chronic intractable pain secondary to post-herpetic neuralgia. CASE SUMMARY: A 78-year-old man presented with severe intractable post herpetic neuralgic pain...
June 20, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28615966/acute-physiological-and-electrical-accentuation-of-vagal-tone-has-no-effect-on-pain-or-gastrointestinal-motility-in-chronic-pancreatitis
#14
Jacob Juel, Christina Brock, Søren S Olesen, Adnan Madzak, Adam D Farmer, Qasim Aziz, Jens B Frøkjær, Asbjørn Mohr Drewes
BACKGROUND: The effective management of pain in chronic pancreatitis (CP) remains a therapeutic challenge. Analgesic drugs, such as opioids, and the underlying pathology can impair gut function. The autonomic nervous system influences hormone secretion and gut motility. In healthy volunteers, electrical (using noninvasive transcutaneous vagal nerve stimulation [t-VNS]) and physiological (using deep slow breathing [DSB]) modulation of parasympathetic tone results in pain attenuation and enhanced gut motility...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28604402/the-role-of-nonpharmacologic-therapies-in-management-of-chronic-pelvic-pain-what-to-do-when-surgery-fails
#15
Sara R Till, Heather N Wahl, Sawsan As-Sanie
PURPOSE OF REVIEW: To provide an update on nonsurgical and nonpharmacologic strategies for the management of chronic pelvic pain (CPP). RECENT FINDINGS: Effective treatment of patients with CPP requires a multifaceted approach, with thoughtful consideration of surgical, pharmacologic, and nonpharmacologic strategies. Evidence for physical therapy and trigger point injections for treatment of myofascial components of CPP is increasing. Neuromodulation techniques, such as percutaneous tibial nerve stimulation and transcutaneous electrical stimulation, have limited but favorable preliminary data in patients with CPP...
August 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28569120/burning-mouth-syndrome
#16
Satu K Jääskeläinen, Alain Woda
Objective To review the clinical entity of primary burning mouth syndrome (BMS), its pathophysiological mechanisms, accurate new diagnostic methods and evidence-based treatment options, and to describe novel lines for future research regarding aetiology, pathophysiology, and new therapeutic strategies. Description Primary BMS is a chronic neuropathic intraoral pain condition that despite typical symptoms lacks clear clinical signs of neuropathic involvement. With advanced diagnostic methods, such as quantitative sensory testing of small somatosensory and taste afferents, neurophysiological recordings of the trigeminal system, and peripheral nerve blocks, most BMS patients can be classified into the peripheral or central type of neuropathic pain...
June 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28551531/transcranial-direct-current-stimulation-tdcs-and-its-influence-on-analgesics-effectiveness-in-patients-suffering-from-migraine-headache
#17
Anna Przeklasa-Muszyńska, Magdalena Kocot-Kępska, Jan Dobrogowski, Maciej Wiatr, Joanna Mika
BACKGROUND: Headache is one of the most common conditions troubling nearly 45% of the world's population. Migraine headache itself, being more common among women, affects 7-18% of people. As much as 20-30% of the population report accompanying aura and neurological symptoms. In many cases, migraine headache can be effectively treated with suitably selected pharmacotherapies which include drugs used in symptomatic treatment. Frequent occurrence of the condition is treated with prophylaxis, which often fails...
March 1, 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/28521018/stereotactic-radiosurgery-for-the-treatment-of-chronic-intractable-pain-a-systematic-review
#18
Dustin G Roberts, Nader Pouratian
BACKGROUND: Since the advent of neuromodulation, the role and efficacy of stereotactic radiosurgery (SRS) for chronic pain has not been carefully scrutinized. OBJECTIVE: To perform a systematic review to evaluate the clinical efficacy, both short- and long-term, of SRS for the treatment of chronic intractable pain. METHODS: A systematic search in PubMed, Web of Science, and PsycINFO was performed using keywords and controlled vocabulary. The search included peer-reviewed articles reporting clinical outcomes of SRS for chronic pain with a minimum 3-mo follow-up for nonmalignant and 1 mo for malignant pain...
May 17, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28518084/subcutaneous-trigeminal-nerve-field-stimulation-for-refractory-facial-pain
#19
Martin Jakobs, Sigrid Schuh-Hofer, Andreas Unterberg, Rezvan Ahmadi
Chronic or neuropathic trigeminal facial pain can be challenging to treat. Neurosurgical procedures should be applied when conservative treatment fails. Neuromodulation techniques for chronic facial pain include deep brain stimulation and motor cortex stimulation, which are complex to perform. Subcutaneous nerve field stimulation is certified for chronic back pain and is the least invasive form of neuromodulation. We applied this technique to treat chronic and neuropathic trigeminal pain as an individual therapy concept...
May 10, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28505029/treatment-options-for-failed-back-surgery-syndrome-patients-with-refractory-chronic-pain-an-evidence-based-approach
#20
Kasra Amirdelfan, Lynn Webster, Lawrence Poree, Vishad Sukul, Porter McRoberts
STUDY DESIGN: A significant number of lumbar postsurgical patients continue to suffer persistent pain and limited function and are termed to have "Failed back surgery syndrome" (FBSS). This review evaluates clinical trial data for the treatment of FBSS patients. OBJECTIVE: Using an evidence-based approach to evaluate FBSS treatments will assist clinicians in choosing the most effective options for FBSS patients. Furthermore, reducing the utilization of less effective therapies may result in substantial financial savings for this patient population...
July 15, 2017: Spine
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