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Neuromodulation for pain

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.
March 15, 2018: European Urology Focus
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...
March 9, 2018: Experimental Neurology
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
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
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
Abdullah Ahmed Ghazi, Malak Abuzgaya, Mai Banakhar, Magdy Hassouna
Objective: The aim of the current research project was to study the role of the Neurometer® as a tool to predict responders to sacral neuromodulation therapy (SNM). Material and methods: This was a prospective, open study in male and female patients, aged 18 and over with voiding dysfunction [non-obstructive retention and/or frequency/ urgency syndrome]. The first group underwent a screening test to evaluate percutaneous nerve functions (PNE) and to determine whether they are candidates for SNM with the InterStim® ...
January 2018: Turkish Journal of Urology
Fang Luo, Jingjing Lu, Nan Ji
BACKGROUND AND AIMS: No ideal therapeutic method currently exists for refractory idiopathic supraorbital neuralgia patients who don't respond to conservative therapy, including medications and nerve blocks. Pulsed radiofrequency is a neuromodulation technique that does not produce sequelae of nerve damage after treatment. However, the efficacy of percutaneous pulsed radiofrequency for the treatment of refractory idiopathic supraorbital neuralgia is still not clear. The purpose of our study was to evaluate the efficacy and safety of pulsed radiofrequency treatment of the supraorbital nerve for refractory supraorbital neuralgia patients...
February 26, 2018: Pain Practice: the Official Journal of World Institute of Pain
S Senova, C Poupon, J Dauguet, H J Stewart, G P Dugué, C Jan, K Hosomi, G S Ralph, L Barnes, X Drouot, C Pouzat, J F Mangin, F Pain, I Doignon, R Aron-Badin, E Brouillet, E S Boyden, K A Mitrophanous, P Hantraye, S Palfi
Dissecting neural circuitry in non-human primates (NHP) is crucial to identify potential neuromodulation anatomical targets for the treatment of pharmacoresistant neuropsychiatric diseases by electrical neuromodulation. How targets of deep brain stimulation (DBS) and cortical targets of transcranial magnetic stimulation (TMS) compare and might complement one another is an important question. Combining optogenetics and tractography may enable anatomo-functional characterization of large brain cortico-subcortical neural pathways...
February 20, 2018: Scientific Reports
Ru-Rong Ji, Andrea Nackley, Yul Huh, Niccolò Terrando, William Maixner
Chronic pain is maintained in part by central sensitization, a phenomenon of synaptic plasticity, and increased neuronal responsiveness in central pain pathways after painful insults. Accumulating evidence suggests that central sensitization is also driven by neuroinflammation in the peripheral and central nervous system. A characteristic feature of neuroinflammation is the activation of glial cells, such as microglia and astrocytes, in the spinal cord and brain, leading to the release of proinflammatory cytokines and chemokines...
February 19, 2018: Anesthesiology
Mats De Jaeger, Robbert-Jan van Hooff, Lisa Goudman, Alexis Valenzuela Espinoza, Raf Brouns, Martine Puylaert, Wim Duyvendak, Maarten Moens
Background: Spinal cord stimulation (SCS) is a proven and effective treatment for neuropathic pain conditions such as failed back surgery syndrome (FBSS). The hypothesis that different settings for SCS parameters activate unique, pain-relieving mechanisms has boosted the development of various SCS paradigms. High density spinal cord stimulation (HD-SCS) is one of those promising, novel stimulation forms characterized by subthreshold stimulation, delivering more pulses per second and a higher pulse density to the spinal cord than conventional SCS...
June 2017: Anesthesiology and Pain Medicine
Krishnan Chakravarthy, Alexander R Kent, Adil Raza, Fang Xing, Thomas M Kinfe
BACKGROUND: Burst spinal cord stimulation (SCS) technology uses a novel waveform that consists of closely packed high-frequency electrical impulses followed by a quiescent period. Within the growing field of neuromodulation, burst stimulation is unique in that it mimics the natural burst firing of the nervous system, in particular the thalamo-cingulate rhythmicity, resulting in modulation of the affective and attentional components of pain processing (e.g., medial thalamic pathways). STUDY DESIGN: A review of preclinical and clinical studies regarding burst SCS for various chronic pain states...
February 12, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Bruna M Santos, Emanuela G Garattini, Luiz G S Branco, Christie R A Leite-Panissi, Glauce C Nascimento
Hydrogen sulfide (H2S) is an endogenous neuromodulator produced mainly by the enzyme cystathionine gamma-lyase (CSE) in peripheral tissues. A pronociceptive role of endogenously produced H2S has been previously reported by our group in a model of orofacial inflammatory pain. Using the established persistent orofacial pain rat model induced by complete Freund's adjuvant (CFA) injection into temporomandibular joint (TMJ), we have now investigated the putative role of endogenous H2S modulating hypernociceptive responses...
February 6, 2018: Physiology & Behavior
Lien-Chen Wu, Pei-Wei Weng, Chia-Hsien Chen, Yi-You Huang, Yang-Hwei Tsuang, Chang-Jung Chiang
BACKGROUND AND OBJECTIVES: This study is a meta-analysis of randomized controlled trials comparing the efficacy of transcutaneous electrical nerve stimulation (TENS) to a control and to other nerve stimulation therapies (NSTs) for the treatment of chronic back pain. METHODS: Citations were identified in MEDLINE, the Cochrane Library, Google Scholar, and through June 2014 using the following keywords: nerve stimulation therapy, transcutaneous electrical nerve stimulation, back pain, chronic pain...
February 1, 2018: Regional Anesthesia and Pain Medicine
Susan Dababou, Cristina Marrocchio, Roberto Scipione, Hans-Peter Erasmus, Pejman Ghanouni, Michele Anzidei, Carlo Catalano, Alessandro Napoli
Cancer-related pain affects up to 80% of patients with malignancies. Pain is an important distressing symptom that diminishes the quality of life and negatively affects the survival of patients. Opioid analgesics are generally the primary therapy for cancer-related pain, with surgery, radiation therapy, chemotherapy, and other interventions used in cases of treatment-resistant pain. These treatments, which can be associated with substantial side effects and systemic toxicity, may not be effective. High-intensity focused ultrasound is an entirely noninvasive technique that is approved for treatment of uterine fibroids, bone metastases, and essential tremors...
January 30, 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Søren S Olesen, Theresa Krauss, Ihsan Ekin Demir, Oliver H Wilder-Smith, Güralp O Ceyhan, Pankaj J Pasricha, Asbjørn M Drewes
Introduction: Chronic pancreatitis (CP) is a disease characterized by inflammation of the pancreas resulting in replacement of the normal functioning parenchyma by fibrotic connective tissue. This process leads to progressively impairment of exocrine and endocrine function and many patients develop a chronic pain syndrome. Objectives: We aimed to characterize the neurobiological signature of pain associated with CP and to discuss its implications for treatment strategies...
November 2017: Pain Reports (Baltimore, Md.)
Mohammad S Rahnama'i, Tom Marcelissen, Apostolos Apostolidis, Nikolaus Veit-Rubin, Brigitte Schurch, Linda Cardozo, Roger Dmochowski
AIMS: This manuscript aims to address the evidence availale in the literature on the efficacy of Botulinum Toxin A (BoNT-A) and sacral neuromodulation (SNM) in patients suffering from Interstitial Cystitis (IC)/BPS and propose further research to identify mechanisms of action and establish the clinical efficacy of either therapy. METHODS: At the International Consultation on Incontinence-Research Society (ICI-RS) in 2017, a panel of Functional Urologists and Urogynaecologists participated in a Think Tank (TT) discussing the management of IC/BPS by BoNT-A and SNM, using available data from both PubMed and Medicine literature searches...
January 24, 2018: Neurourology and Urodynamics
Yuangui Zhang, Fanceng Ji, Gongming Wang, Dong He, Le Yang, Mengyuan Zhang
The mechanistic target of rapamycin (mTOR) has been demonstrated to mediate pain-related aversion induced by formalin in the rostral anterior cingulate cortex (rACC). However, it remains unclear the signaling pathways and regulatory proteins involved. In the rACC, brain-derived neurotrophic factor (BDNF), an activity-dependent neuromodulator, has been shown to play a role in the development and persistence of chronic pain. In this study, we used a rat formalin-induced inflammatory pain model to demonstrate BDNF up-regulation in the rACC...
January 20, 2018: Neurochemical Research
Tzu-Hsien Lai, Shuu-Jiun Wang
Medication overuse headache (MOH) is a secondary headache syndrome defined as the deterioration of the headache associated with the overuse of analgesics. The prevalence of MOH is 1-2% in the general population and even up to 50% in special clinics. Overuse of abortive medications is highly associated with chronic daily headaches and also a known risk factor for headache evolution. Possible mechanisms include neural plasticity changes such as sensitization and defective endogenous pain inhibition. Psychological studies have suggested dependence, even addiction, in patients with MOH...
January 16, 2018: Current Pain and Headache Reports
Manuela Tutolo, Enrico Ammirati, John Heesakkers, Thomas M Kessler, Kenneth M Peters, Tina Rashid, Karl-Dietrich Sievert, Michele Spinelli, Giacomo Novara, Frank Van der Aa, Dirk De Ridder
CONTEXT: Neuromodulation is considered in patients with non-neurogenic lower urinary tract dysfunction (LUTD) not responsive to conservative treatment. OBJECTIVE: To systematically review the available studies on efficacy and safety of sacral neuromodulation (SNM) and percutaneous tibial nerve stimulation (PTNS) in non-neurogenic LUTDs not responsive to conservative treatments. EVIDENCE ACQUISITION: A literature research was conducted in PubMed/Medline and Scopus, restricted to articles in English, published between January 1998 and June 2017, with at least 20 patients and 6 mo of follow-up...
January 11, 2018: European Urology
Jae-Hwan Jang, Ji-Yeun Park, Ju-Young Oh, Sun-Jeong Bae, Hyunchul Jang, Songhee Jeon, Jongpil Kim, Hi-Joon Park
The melanin-concentrating hormone (MCH) is a peptidergic neuromodulator synthesized by neurons in the lateral hypothalamus and zona incerta. MCHergic neurons project throughout the central nervous system, indicating the involvements of many physiological functions, but the role in pain has yet to be determined. In this study, we found that pMCH-/- mice showed lower baseline pain thresholds to mechanical and thermal stimuli than did pMCH+/+ mice, and the time to reach the maximum hyperalgesic response was also significantly earlier in both inflammatory and neuropathic pain...
January 15, 2018: Scientific Reports
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