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Neuromodulation for pain

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https://www.readbyqxmd.com/read/28521018/stereotactic-radiosurgery-for-the-treatment-of-chronic-intractable-pain-a-systematic-review
#1
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
#2
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-fbss-patients-with-refractory-chronic-pain-an-evidence-based-approach
#3
Kasra Amirdelfan, Lynn Webster, Lawrence Poree, Vishad Sukul, Porter McRoberts
STUDY DESIGN: A significant number of lumbar post-surgical 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...
April 12, 2017: Spine
https://www.readbyqxmd.com/read/28486758/stimulation-of-the-l2-l3-dorsal-root-ganglia-induces-effective-pain-relief-in-the-low-back
#4
Frank Huygen, Liong Liem, William Cusack, Jeffery Kramer
INTRODUCTION: Chronic low back pain affects millions of people worldwide and can arise through a variety of clinical origins. In the case of Failed Back Surgery Syndrome (FBSS), previous surgical procedures can contribute to low back pain that is often unresponsive to intervention. Although spinal cord stimulation can be an effective treatment modality, it does not provide sufficient pain relief for some intractable cases. Recently, alternative neuromodulation options have been developed, including dorsal root ganglion (DRG) stimulation...
May 9, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28463855/noncardiac-chest-pain-diagnosis-and-management
#5
Takahisa Yamasaki, Ronnie Fass
PURPOSE OF REVIEW: Noncardiac chest pain (NCCP) has been defined as recurrent chest pain that is indistinguishable from ischemic heart pain after excluding a cardiac cause. NCCP is a common and highly challenging clinical problem in Gastrointestinal practice that requires targeted diagnostic assessment to identify the underlying cause of the symptoms. Treatment is tailored according to the cause of NCCP: gastroesophageal reflux disease (GERD), esophageal dysmotility or functional chest pain...
May 1, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28440001/treating-low-back-pain-with-combined-cerebral-and-peripheral-electrical-stimulation-a-randomized-double-blind-factorial-clinical-trial
#6
F A Hazime, A F Baptista, D G de Freitas, R L Monteiro, R L Maretto, R H Hasue, S M A João
BACKGROUND: Recent evidence suggests that chronic low back pain is associated with plastic changes in the brain that can be modified by neuromodulation strategies. This study investigated the efficacy of transcranial direct current stimulation (tDCS) combined simultaneously with peripheral electrical stimulation (PES) for pain relief, disability and global perception in patients with chronic low back pain (CLBP). METHODS: Ninety-two patients with CLBP were randomized to receive 12 sessions on nonconsecutive days of anodal tDCS (primary motor cortex, M1), 100 Hz sensory PES (lumbar spine), tDCS + PES or sham tDCS + PES...
April 25, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28437824/-neuromodulation-for-the-treatment-of-chronic-pain-what-is-useful
#7
Volker Tronnier
Neuromodulatory techniques have replaced the earlier performed neurolesional procedures to treat chronic pain syndromes with only a few exceptions. Nevertheless these procedures are invasive with respective risks and complications and therefore conservative physical, psychological pharmacological as well as interventional treatments should be performed first. Because this therapy is costly, the indication has to be proven carefully with a strict patient selection and also the long-term results have to be considered...
April 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#8
Peter Staats
STUDY DESIGN: A review of the literature evaluating clinical trials of chronic back pain. OBJECTIVE: To assist physicians in assessing the quality of clinical trial data to make the most informed treatment decisions. SUMMARY OF BACKGROUND DATA: Chronic pain is a tremendous public health issue, affecting close to 100 million adults in the United States, and costs the American people billions of dollars. One traditional treatment approach, the long-term use of opiate medications, has recently come under intense scrutiny for problems with complications, diversion, abuse, addiction and lack of efficacy...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28399549/cost-effectiveness-data-regarding-spinal-cord-stimulation-for-low-back-pain
#9
Christian Hoelscher, Jonathan Riley, Chengyuan Wu, Ashwini Sharan
STUDY DESIGN: Review of published literature pertaining to spinal cord stimulation cost data analysis. OBJECTIVE: To acquire, organize, and succinctly summarize the available literature regarding the costs associated with, and the cost-effectiveness of, spinal cord stimulation. SUMMARY OF BACKGROUND DATA: Chronic back and limb pain is a pervasive complaint in modern society, with estimated annual costs of medical care greater than $100 billion...
April 10, 2017: Spine
https://www.readbyqxmd.com/read/28380672/randomized-clinical-trial-of-deep-brain-stimulation-for-poststroke-pain
#10
Scott F Lempka, Donald A Malone, Bo Hu, Kenneth B Baker, Alexandria Wyant, John G Ozinga, Ela B Plow, Mayur Pandya, Cynthia S Kubu, Paul J Ford, Andre G Machado
OBJECTIVE: The experience with deep brain stimulation (DBS) for pain is largely based on uncontrolled studies targeting the somatosensory pathways, with mixed results. We hypothesized that targeting limbic neural pathways would modulate the affective sphere of pain and alleviate suffering. METHODS: We conducted a prospective, double-blinded, randomized, placebo-controlled, crossover study of DBS targeting the ventral striatum/anterior limb of the internal capsule (VS/ALIC) in 10 patients with poststroke pain syndrome...
May 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28368982/spinal-cord-stimulation-in-chronic-pain-mode-of-action
#11
Ricardo Vallejo, Kerry Bradley, Leonardo Kapural
OBJECTIVE: A review of the literature that presents a perspective on mechanisms of actions behind spinal cord stimulation (SCS) therapy for chronic pain. SUMMARY OF BACKGROUND DATA: SCS is an effective therapeutic alternative for the treatment of intractable chronic pain. Its application has been mostly based on the Gate Control Theory (GCT) of pain. Computational models have been fundamental on the understanding of clinical observations and the design of therapies that provide optimal neuromodulation...
March 31, 2017: Spine
https://www.readbyqxmd.com/read/28367344/sacral-neuromodulation-foray-into-chronic-pelvic-pain-in-end-stage-endometriosis
#12
Maija Lavonius, Pia Suvitie, Pirita Varpe, Heikki Huhtinen
Excision of all endometriotic lesions is the method of choice in the treatment of severe endometriosis resistant to medical therapy. The infiltrating nature of the disease as well as extensive surgery may, however, cause chronic pain that cannot be relieved by either surgery or hormonal treatment. As a pilot treatment, we tested the effect of sacral neuromodulation (SNM) for four endometriosis patients suffering chronic pelvic pain and pelvic organ dysfunction after radical surgical treatment. Three out of four patients reported improvement in their symptoms during the neuromodulation testing period and a permanent pulse generator was installed...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28352201/tibial-nerve-stimulation-with-a-miniature-wireless-stimulator-in-chronic-peripheral-neuropathic-pain
#13
Paweł Sokal, Marek Harat, Piotr Zieliński, Sara Kierońska
Peripheral neuropathic pain (PNP) and complex regional pain syndrome (CRPS) can be effectively treated with peripheral nerve stimulation. In this clinical trial report, effectiveness of novel, miniature, wirelessly controlled microstimulator of tibial nerve in PNP and CRPS was evaluated. In this pilot study the average preoperative visual analog scale (VAS) score in six patients was 7.5, with 1, 3 and 6 months: 2.6 (p=0.03), 1.6 (p=0.03), and 1.3 (p=0.02), respectively. The mean average score in the six patients a week preceding the baseline visit was 7...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28350939/the-advancing-role-of-neuromodulation-for-the-management-of-chronic-treatment-refractory-pain
#14
Mohammed F Shamji, Cecile De Vos, Ashwini Sharan
Neuropathic pain is a common cause of disability and health care utilization. While judicious pharmacotherapy and management of comorbid psychological distress can provide for improved quality of life, some patients with treatment-refractory disease require more invasive therapies. Spinal cord stimulation can provide for improvement in pain and decrease in medication utilization, with level 1 evidence supporting its use across various pain etiologies including persistent postoperative neuropathic pain, complex regional pain syndrome, chronic inoperable limb ischemia, treatment refractory angina, and painful diabetic neuropathy...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28349992/central-neuromodulators-for-treating-functional-gi-disorders-a-primer
#15
REVIEW
W Harley Sobin, Thomas W Heinrich, Douglas A Drossman
Patients with functional GI disorders (FGIDs) are commonplace in the gastroenterologist's practice. A number of these patients may be refractory to peripherally acting agents, yet respond to central neuromodulators. There are benefits and potential adverse effects to using TCAs, SSRIs, SNRIs, atypical antipsychotics, and miscellaneous central neuromodulators in these patients. These agents can benefit mood, pain, diarrhea, constipation, nausea, sleep, and depression. The mechanisms by which they work, the differences between classes and individual agents, and the various adverse effects are outlined...
May 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28337820/selective-radiofrequency-stimulation-of-the-dorsal-root-ganglion-drg-as-a-method-for-predicting-targets-for-neuromodulation-in-patients-with-post-amputation-pain-a-case-series
#16
Corey W Hunter, Ajax Yang, Tim Davis
OBJECTIVE: While spinal cord stimulation (SCS) has established itself as an accepted and validated treatment for neuropathic pain, there are a number of conditions where it has experienced less, long-term success: post amputee pain (PAP) being one of them. Dorsal root ganglion (DRG) stimulation has shown great promise, particularly in conditions where traditional SCS has fallen short. One major difference between DRG stimulation and traditional SCS is the ability to provide focal stimulation over targeted areas...
March 23, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28335379/the-role-of-adenosine-signaling-in-headache-a-review
#17
REVIEW
Nathan T Fried, Melanie B Elliott, Michael L Oshinsky
Migraine is the third most prevalent disease on the planet, yet our understanding of its mechanisms and pathophysiology is surprisingly incomplete. Recent studies have built upon decades of evidence that adenosine, a purine nucleoside that can act as a neuromodulator, is involved in pain transmission and sensitization. Clinical evidence and rodent studies have suggested that adenosine signaling also plays a critical role in migraine headache. This is further supported by the widespread use of caffeine, an adenosine receptor antagonist, in several headache treatments...
March 13, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28303458/calcitonin-gene-related-peptide-and-pain-a-systematic-review
#18
REVIEW
Wendy Sophie Schou, Sait Ashina, Faisal Mohammad Amin, Peter J Goadsby, Messoud Ashina
BACKGROUND: Calcitonin gene-related peptide (CGRP) is widely distributed in nociceptive pathways in human peripheral and central nervous system and its receptors are also expressed in pain pathways. CGRP is involved in migraine pathophysiology but its role in non-headache pain has not been clarified. METHODS: We performed a systematic literature search on PubMed, Embase and ClinicalTrials.gov for articles on CGRP and non-headache pain covering human studies including experimental studies and randomized clinical trials...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28301217/neuromodulation-with-percutaneous-electrical-nerve-field-stimulation-is-associated-with-reduction-in-signs-and-symptoms-of-opioid-withdrawal-a-multisite-retrospective-assessment
#19
Adrian Miranda, Arturo Taca
BACKGROUND: Finding an effective, non-pharmacological approach to treat opioid withdrawal could remove some of the barriers associated with pharmacotherapy. The BRIDGE® is a noninvasive, percutaneous electrical nerve field stimulator developed to target pain. OBJECTIVES: This pilot study aimed to determine (1) the effects of the BRIDGE on withdrawal scores during the induction phase of opioid withdrawal therapy, (2) the percentage of subjects who successfully transitioned to medication assisted therapy (MAT)...
March 16, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28296137/percutaneous-peripheral-nerve-stimulation-for-the-treatment-of-chronic-low-back-pain-two-clinical-case-reports-of-sustained-pain-relief
#20
Leonardo Kapural, Christopher A Gilmore, John Chae, Richard L Rauck, Steven P Cohen, Michael F Saulino, Amorn Wongsarnpigoon, Meredith J McGee, Joseph W Boggs
As the leading cause of disability among U.S. adults, chronic low back pain (LBP) is one of the most prevalent and challenging musculoskeletal conditions. Neuromodulation provides an opportunity to reduce or eliminate the use of opioids to treat chronic LBP, but the cost and invasiveness of existing methods have limited its broad adoption, especially earlier in the treatment continuum. The present case report details the results of a novel method of short-term percutaneous peripheral nerve stimulation (PNS) in 2 subjects with chronic LBP...
March 14, 2017: Pain Practice: the Official Journal of World Institute of Pain
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