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Neuromodulation of the dorsal root ganglion

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https://www.readbyqxmd.com/read/29026048/spinal-cord-stimulation-for-chronic-non-cancer-pain-a-review-of-current-evidence-and-practice
#1
S Sc Wong, C W Chan, C W Cheung
Spinal cord stimulation provides analgesia through electrical stimulation of the dorsal column of the spinal cord via electrode leads placed into the epidural space. In traditional tonic stimulation, a painful sensation is replaced with paraesthesia. Spinal cord stimulation is effective in reducing neuropathic pain, enhancing function, and improving quality of life in different chronic pain conditions. Currently, there is most evidence to support its use for failed back surgery syndrome when multidisciplinary conventional management is unsuccessful...
October 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28973357/a-prospective-analysis-of-neuromonitoring-for-confirmation-of-lead-placement-in-dorsal-root-ganglion-stimulation
#2
Steven M Falowski, Andreas Dianna
BACKGROUND: Dorsal root ganglion stimulation is a neuromodulation therapy used for chronic neuropathic pain. Typically, patients are awakened intraoperatively to confirm adequate placement. OBJECTIVE: To determine whether neuromonitoring can confirm placement in an asleep patient. METHODS: This is a prospective analysis of 12 leads placed in 6 patients. Lead confirmation was confirmed by awake intraoperative testing, as well as asleep testing utilizing neuromonitoring...
August 2, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28827823/comparison-of-efficacy-of-continuous-epidural-block-and-pulsed-radiofrequency-to-the-dorsal-root-ganglion-for-management-of-pain-persisting-beyond-the-acute-phase-of-herpes-zoster
#3
COMPARATIVE STUDY
Eung Don Kim, Young In Lee, Hue Jung Park
BACKGROUND: There is little evidence regarding the effectiveness of intervention methods in the treatment of zoster-related pain (ZAP) after the acute phase of zoster. Generally, if ZAP remains after more than 180 days from its onset, the likelihood of pain reduction is very low; this condition is considered as a "well established" post-herpetic neuralgia (PHN). Although the clinical efficacy of intrathecal steroid injection and spinal cord stimulation (SCS) for ZAP management has been reported, these interventions are not widely used due to inherent disadvantages...
2017: PloS One
https://www.readbyqxmd.com/read/28676344/crispr-epigenome-editing-of-akap150-in-drg-neurons-abolishes-degenerative-ivd-induced-neuronal-activation
#4
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...
September 6, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/28530662/pd-l1-inhibits-acute-and-chronic-pain-by-suppressing-nociceptive-neuron-activity-via-pd-1
#5
Gang Chen, Yong Ho Kim, Hui Li, Hao Luo, Da-Lu Liu, Zhi-Jun Zhang, Mark Lay, Wonseok Chang, Yu-Qiu Zhang, Ru-Rong Ji
Programmed cell death ligand-1 (PD-L1) is typically produced by cancer cells and suppresses immunity through the receptor PD-1 expressed on T cells. However, the role of PD-L1 and PD-1 in regulating pain and neuronal function is unclear. Here we report that both melanoma and normal neural tissues including dorsal root ganglion (DRG) produce PD-L1 that can potently inhibit acute and chronic pain. Intraplantar injection of PD-L1 evoked analgesia in naive mice via PD-1, whereas PD-L1 neutralization or PD-1 blockade induced mechanical allodynia...
July 2017: Nature Neuroscience
https://www.readbyqxmd.com/read/28486758/stimulation-of-the-l2-l3-dorsal-root-ganglia-induces-effective-pain-relief-in-the-low-back
#6
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/28350939/the-advancing-role-of-neuromodulation-for-the-management-of-chronic-treatment-refractory-pain
#7
REVIEW
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/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
#8
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...
October 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28160397/alternate-intraspinal-targets-for-spinal-cord-stimulation-a-systematic-review
#9
REVIEW
George C Chang Chien, Nagy Mekhail
BACKGROUND: Conventional dorsal column spinal cord stimulation (SCS) provides less than optimal pain relief for certain pain syndromes and anatomic pain distributions. Practitioners have sought to treat these challenging therapeutic areas with stimulation of alternate intraspinal targets. OBJECTIVE: To identify and systematically review the evidence for the value neuromodulating specific neuronal targets within the spinal canal to achieve relief of chronic pain...
October 2017: Neuromodulation: Journal of the International Neuromodulation Society
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
#10
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...
February 15, 2017: NeuroImage
https://www.readbyqxmd.com/read/27676680/intrathecal-bupivacaine-monotherapy-with-a-retrograde-catheter-for-the-management-of-complex-regional-pain-syndrome-of-the-lower-extremity
#11
W Porter McRoberts, Catalina Apostol, Abdul Haleem
UNLABELLED: Complex regional pain syndrome (CRPS) presents a therapeutic challenge due to its many presentations and multifaceted pathophysiology. There is no approved treatment algorithm and clinical interventions are often applied empirically. In cases of CRPS where symptoms are localized to an extremity, a targeted treatment is indicated. We describe the use of intrathecal bupivacaine monotherapy, delivered through a retrograde catheter, in the treatment of CRPS affecting the lower extremity...
September 2016: Pain Physician
https://www.readbyqxmd.com/read/27445503/a-review-of-spinal-cord-stimulation-systems-for-chronic-pain
#12
REVIEW
Paul Verrills, Chantelle Sinclair, Adele Barnard
Spinal cord stimulation (SCS) applications and technologies are fast advancing. New SCS technologies are being used increasingly in the clinical environment, but often there is a lag period between the clinical application and the publishing of high-quality evidence on safety and efficacy. Recent developments will undoubtedly expand the applicability of SCS, allowing more effective and individualized treatment for patients, and may have the potential to salvage patients who have previously failed neuromodulation...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27135465/photobiomodulation-of-the-dorsal-root-ganglion-for-the-treatment-of-low-back-pain-a-pilot-study
#13
Vanessa Milanesi Holanda, Maria Cristina Chavantes, Daniela Fatima Teixeira Silva, Carlos Vanderlei M de Holanda, José Oswaldo de Oliveira, Xingjia Wu, Juanita J Anders
BACKGROUND AND OBJECTIVE: Chronic low back pain is a worldwide public health issue with high socioeconomic impact. The aim of this study was to determine the efficacy of laser irradiation of the dorsal root ganglion of the second lumbar spinal nerve for chronic axial low back pain compared to lidocaine injection and radiofrequency treatment. STUDY DESIGN/MATERIALS AND METHODS: Twenty-eight patients were randomly divided into three treatment groups: lidocaine injection, radiofrequency, or laser...
September 2016: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/27123351/s3-dorsal-root-ganglion-nerve-root-stimulation-for-refractory-postsurgical-perineal-pain-technical-aspects-of-anchorless-sacral-transforaminal-lead-placement
#14
X Zuidema, J Breel, F Wille
Chronic perineal pain limits patients in physical and sexual activities, leading to social and psychological distress. In most cases, this pain develops after surgery in the urogenital area or as a consequence of trauma. Neuromodulation is one of the options in chronic postsurgical perineal pain treatment. We present a case of refractory perineal pain after right sided surgical resection of a Bartholin's cyst which was treated with third sacral nerve root/dorsal root ganglion stimulation using the transforaminal approach...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/26914618/dexmedetomidine-as-a-sedative-in-the-awake-implantation-of-a-neuromodulative-system
#15
Feline F J A Ter Bruggen, Ismail Eralp, Leo Leliveld, Chris Jansen, Dirk L Stronks, Frank J P M Huygen
OBJECTIVE: During implantation of a neuromodulative system, high patient satisfaction is closely associated with the equilibrium between an effective analgesia and sedation regimen, and the possibility for the patient to be awake and cooperative during procedure. This study assessed the efficacy of the sedative dexmedetomidine to achieve this balance, with patient satisfaction as the primary outcome. METHODS: Ten patients undergoing implantation of a dorsal column and dorsal root ganglion stimulator received dexmedetomidine (1 mcg/kg over 10 minutes, followed by 0...
February 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/26914499/management-of-postherniorrhaphy-chronic-neuropathic-groin-pain-a-role-for-dorsal-root-ganglion-stimulation
#16
REVIEW
Liong Liem, Nagy Mekhail
Chronic neuropathic groin pain is a sequela of hernia surgery that occurs at unacceptably high rates, causing widespread impacts on quality of life. Although the medical community is beginning to recognize the role of surgical technique in the initiation and maintenance of postherniorrhaphy neuropathic pain, little information exists regarding pain management strategies for this condition. This review presents a summary of the pain condition state, its treatment options, and treatment recommendations. Both literature review and clinical experience were used to develop a proposed a treatment algorithm for the treatment of postherniorrhaphy pain...
September 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/26530058/emerging-treatments-for-neuropathic-pain
#17
REVIEW
Bruno L Pessoa, Gabriel Escudeiro, Osvaldo J M Nascimento
Neuropathic pain is a series of well-known conditions caused by diseases or lesions to the somatosensory system. Due to the better understanding of the pathophysiology of neuropathic pain, previously unexplored therapies have been used with encouraging results. As such, Acetyl-L-carnitine (ALC), Alpha-lipoic-acid (ALA), cannabinoids, Clonidine, EMA401, Botulinum Toxin type A, and new voltage-gated sodium channel blockers, can be cited. Furthermore, new modalities in neuromodulation such as high-frequency spinal cord stimulation, burst stimulation, dorsal root ganglion stimulation, transcranial direct current stimulation, and many others have been showing exciting results...
December 2015: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/26441011/exogenous-brain-derived-neurotrophic-factor-relieves-pain-symptoms-of-diabetic-rats-by-reducing-excitability-of-dorsal-root-ganglion-neurons
#18
Lei Li, Ting Yu, Liling Yu, Haijun Li, Yongjuan Liu, Dongqin Wang
Diabetic peripheral neuropathy (DPN) is a common complication of diabetes lacking of effective treatments. Enhanced excitability of dorsal root ganglion (DRG) neuron plays a crucial role in the progression of diabetic neuropathic hyperalgesia. Brain-derived neurotrophic factor (BDNF) is known as a neuromodulator of nociception, but whether and how BDNF modulates the excitability of DRG neurons in the development of DPN remain to be clarified. This study investigated the role of exogenous BDNF and its high-affinity tropomyosin receptor kinase B (TrkB) in rats with streptozotocin-induced diabetic neuropathic pain...
August 2016: International Journal of Neuroscience
https://www.readbyqxmd.com/read/26394301/stimulation-of-the-dorsal-root-ganglion
#19
REVIEW
Liong Liem
Dorsal root ganglion (DRG) stimulation has recently emerged as a new neuromodulation modality that stays on the intersection of the peripheral and central nervous system. With DRG location within the spinal column and with electrodes for DRG stimulation placed through the intraspinal epidural space, it may make more sense to group DRG stimulation together with more commonly used spinal cord stimulation (SCS) rather than peripheral nerve stimulation (PNS), particularly if one agrees that the stimulation delivered to DRG partly works downstream at the spinal cord level...
2015: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/26268453/dorsal-root-ganglion-drg-stimulation-in-the-treatment-of-phantom-limb-pain-plp
#20
Sam Eldabe, Katja Burger, Heinrich Moser, Daniel Klase, Stefan Schu, Anders Wahlstedt, Bernard Vanderick, Eric Francois, Jeffery Kramer, Jeyakumar Subbaroyan
OBJECTIVES: Phantom limb pain (PLP) is a neuropathic condition in which pain is perceived as arising from an amputated limb. PLP is distinct from, although associated with, pain in the residual limb and nonpainful phantom sensations of the missing limb. Its treatment is extremely challenging; pharmaceutical options, while commonly employed, may be insufficient or intolerable. Neuromodulatory interventions such as spinal cord stimulation have generated mixed results and may be limited by poor somatotopic specificity...
October 2015: Neuromodulation: Journal of the International Neuromodulation Society
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