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Spinal neuromodulation

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https://www.readbyqxmd.com/read/28723864/sacral-neuromodulation-for-fecal-incontinence-a-review-of-the-central-mechanisms-of-action
#1
Paul T J Janssen, Niels Komen, Jarno Melenhorst, Nicole D Bouvy, Ali Jahanshahi, Yasin Temel, Stephanie O Breukink
OBJECTIVE: Fecal incontinence (FI) has a devastating effect on the quality of life and results in social isolation. Sacral neuromodulation (SNM) is proven to be an effective, minimal invasive treatment modality for FI. Despite the increasing application of SNM, the exact mechanisms of action remain unclear. The initial assumption of peripheral motor neurostimulation is not supported by increasing evidence, which report effects of SNM outside the pelvic floor. A new hypothesis states that afferent signals to the brain are essential for a successful therapy...
July 18, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28716325/peripheral-and-sacral-neuromodulation-in-the-treatment-of-neurogenic-lower-urinary-tract-dysfunction
#2
REVIEW
Paholo G Barboglio Romo, Priyanka Gupta
Sacral and peripheral neuromodulation are minimally invasive surgical procedures that are third-line therapy options for the treatment of patients with idiopathic overactive bladder syndrome. There has been interest in their efficacy in the management of neurogenic lower urinary tract dysfunction (NLUTD). Contemporary data suggest promising outcomes for urinary and bowel symptoms in carefully selected patients with spinal cord injury and/or multiple sclerosis. This article reviews the current literature regarding urinary and bowel outcomes in patients with NLUTD and also discusses contemporary studies that suggest that treatment during particular stages of neurologic injury may prevent long-term urinary sequelae...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28699685/pocket-pain-and-neuromodulation-negligible-or-neglected
#3
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/28673064/effects-of-acute-sacral-neuromodulation-at-different-frequencies-on-bladder-overactivity-in-pigs
#4
Xing Li, Limin Liao, Guoqing Chen, Zhaoxia Wang, Han Deng
PURPOSE: We investigated the effects of different stimulation frequencies on the inhibition of bladder overactivity by sacral neuromodulation (SNM) in pigs. METHODS: Implant-driven stimulators were used to stimulate the S3 spinal nerve in 13 pigs. Cystometry was performed by infusing normal saline (NS) or acetic acid (AA). SNM (pulse width, 210 µsec) at frequencies ranging from 5 to 50 Hz was conducted at the intensity threshold at which observable perianal and/or tail movement was induced...
June 2017: International Neurourology Journal
https://www.readbyqxmd.com/read/28666061/conditional-neuromodulation-of-neurogenic-detrusor-overactivity-using-transrectal-stimulation-in-patients-with-spinal-cord-injury-a-proof-of-principle-study
#5
Sarah Louise Knight, Nuwani Edirisinghe, Brian Leaker, Judith Susser, Michael Duncan Craggs
AIMS: A proof of principle study of a novel wearable device to control neurogenic detrusor over-activity in eight male spinal cord injured subjects using conditional neuromodulation. METHODS: Transrectal stimulation was delivered through the device in response to simultaneously recorded external anal sphincter (EAS) contraction as a marker for neurogenic detrusor overactivity (NDO). The effect of conditional neuromodulation on bladder capacity and maximum detrusor pressure was investigated in addition to reliability of dyssynergic sphincter contraction as a marker for NDO...
June 30, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28655149/neuromodulation-of-axon-terminals
#6
Darpan Chakraborty, Dennis Q Truong, Marom Bikson, Hanoch Kaphzan
Understanding which cellular compartments are influenced during neuromodulation underpins any rational effort to explain and optimize outcomes. Axon terminals have long been speculated to be sensitive to polarization, but experimentally informed models for CNS stimulation are lacking. We conducted simultaneous intracellular recording from the neuron soma and axon terminal (blebs) during extracellular stimulation with weak sustained (DC) uniform electric fields in mouse cortical slices. Use of weak direct current stimulation (DCS) allowed isolation and quantification of changes in axon terminal biophysics, relevant to both suprathreshold (e...
June 24, 2017: Cerebral Cortex
https://www.readbyqxmd.com/read/28648406/n-2-morpholin-4-yl-ethyl-2-1naphthyloxy-acetamide-inhibits-the-chronic-constriction-injury-generated-hyperalgesia-via-the-antagonism-of-sigma-1-receptors
#7
Josué Vidal Espinosa-Juárez, Osmar Antonio Jaramillo-Morales, Gabriel Navarrete-Vázquez, Luis Alberto Melo Hernández, Myrna Déciga-Campos, Francisco Javier López-Muñoz
The most used therapeutic treatment to relieve neuropathic pain is that of neuromodulators such as anti-epileptics or anti-depressants; however, there are alternatives that may be potentially useful. The sigma-1 receptor is a therapeutic target that has shown favorable results at preclinical levels. The aim of this study was to evaluate the anti-hyperalgesic effect of N-(2-morpholin-4-yl-ethyl)-2-(1-naphthyloxy) acetamide (NMIN) in a chronic constriction injury model (CCI) and compare it both a sigma-1 antagonist (BD-1063) and also Gabapentin, as well as determine its possible role as an antagonist of sigma-1 receptors...
June 22, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28642680/weight-bearing-over-ground-stepping-in-an-exoskeleton-with-non-invasive-spinal-cord-neuromodulation-after-motor-complete-paraplegia
#8
Parag Gad, Yury Gerasimenko, Sharon Zdunowski, Amanda Turner, Dimitry Sayenko, Daniel C Lu, V Reggie Edgerton
We asked whether coordinated voluntary movement of the lower limbs could be regained in an individual having been completely paralyzed (>4 year) and completely absent of vision (>15 year) using two novel strategies-transcutaneous electrical spinal cord stimulation at selected sites over the spine as well as pharmacological neuromodulation by buspirone. We also asked whether these neuromodulatory strategies could facilitate stepping assisted by an exoskeleton (EKSO, EKSO Bionics, CA) that is designed so that the subject can voluntarily complement the work being performed by the exoskeleton...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28607170/oxytocin-and-serotonin-brain-mechanisms-in-the-non-human-primate
#9
Arthur Lefevre, Nathalie Richard, Mina Jazayeri, Pierre-Aurélien Beuriat, Sylvain Fieux, Luc Zimmer, Jean-René Duhamel, Angela Sirigu
Oxytocin is increasingly studied for its therapeutic potential in psychiatric disorders which are associated with the deregulation of several neurotransmission systems. Studies in rodents demonstrated that the interaction between oxytocin (OT) and serotonin (5-HT) is critical for several aspects of social behavior. Using PET-scan in humans we have recently found that 5-HT 1A receptor (5-HT1AR) function is modified after intra-nasal oxytocin intake. However, the underlying mechanism between OT and 5-HT remains unclear...
June 12, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28576833/spinal-cord-stimulation-reduces-ventricular-arrhythmias-during-acute-ischemia-by-attenuation-of-regional-myocardial-excitability
#10
Kimberly Howard-Quijano, Tatsuo Takamiya, Erica A Dale, Jasmine Kipke, Yukiko Kubo, Tristan Grogan, Andyshea Afyouni, Kalyanam Shivkumar, Aman Mahajan
BACKGROUND: Myocardial ischemia creates autonomic nervous system imbalance and can trigger cardiac arrhythmias. We hypothesize that neuromodulation by spinal cord stimulation (SCS) will attenuate local cardiac sympathoexcitation from ischemia-induced increases in afferent signaling, reduce ventricular arrhythmias, and improve myocardial function during acute ischemia. METHODS: Yorkshire pigs (n=20) were randomized to SCS (50 Hz at 200μsec duration, current 90% motor threshold) or Sham for 30 min prior to ischemia...
June 2, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28526145/alpha-2-agonists
#11
REVIEW
Viet Nguyen, Dawn Tiemann, Edward Park, Ali Salehi
Alpha-2 adrenergic receptors are spread throughout the central and peripheral nervous system, specifically in the pontine locus coeruleus, medullospinal tracts, rostral ventrolateral medulla, and the dorsal horn of the spinal cord. Alpha-2 agonist agents cause neuromodulation in these centers, leading to sedation, analgesia, vasodilatation, and bradycardia with little effect on the respiratory drive, which accounts for their good safety profile. The 2 major drugs in this group are clonidine and dexmedetomidine...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28522414/therapeutic-potential-of-agmatine-for-cns-disorders
#12
REVIEW
Vivian B Neis, Priscila B Rosa, Gislaine Olescowicz, Ana Lúcia S Rodrigues
Agmatine is a neuromodulator that regulates multiple neurotransmitters and signaling pathways. Several studies have focused on elucidating the mechanisms underlying the neuroprotective effects of this molecule, which seems to be mediated by a reduction in oxidative damage, neuroinflammation, and proapoptotic signaling. Since these events are implicated in acute and chronic excitotoxicity-related disorders (ischemia, epilepsy, traumatic brain injury, spinal cord injury, neurodegenerative, and psychiatric disorders) as well as in nociception, agmatine has been proposed as a therapeutic strategy for the treatment of central nervous system (CNS) disorders...
May 15, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28505029/treatment-options-for-failed-back-surgery-syndrome-patients-with-refractory-chronic-pain-an-evidence-based-approach
#13
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
https://www.readbyqxmd.com/read/28486758/stimulation-of-the-l2-l3-dorsal-root-ganglia-induces-effective-pain-relief-in-the-low-back
#14
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/28483393/activation-of-5-ht7-receptors-reverses-nmda-r-dependent-ltd-by-activating-pka-in-medial-vestibular-neurons
#15
Yan-Hai Li, Lei Han, Kenneth Lap Kei Wu, Ying-Shing Chan
The medial vestibular nucleus (MVN) is a major output station for neurons that project to the vestibulo-spinal pathway. MVN neurons show capacity for long-term depression (LTD) during the juvenile period. We investigated LTD of MVN neurons using whole-cell patch-clamp recordings. High frequency stimulation (HFS) robustly induced LTD in 90% of type B neurons in the MVN, while only 10% of type A neurons were responsive, indicating that type B neurons are the major contributors to LTD in the MVN. The neuromodulator serotonin (5-HT) is known to modulate LTD in neural circuits of the cerebral cortex and the hippocampus...
May 5, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28452616/an-ovine-model-of-cerebral-catheter-venography-for-implantation-of-an-endovascular-neural-interface
#16
Thomas James Oxley, Nicholas Lachlan Opie, Gil Simon Rind, Kishan Liyanage, Sam Emmanuel John, Stephen Ronayne, Alan James McDonald, Anthony Dornom, Timothy John Haynes Lovell, Peter John Mitchell, Iwan Bennett, Sebastien Bauquier, Leon Norris Warne, Chris Steward, David Bruce Grayden, Patricia Desmond, Stephen M Davis, Terence John O'Brien, Clive N May
OBJECTIVE Neural interface technology may enable the development of novel therapies to treat neurological conditions, including motor prostheses for spinal cord injury. Intracranial neural interfaces currently require a craniotomy to achieve implantation and may result in chronic tissue inflammation. Novel approaches are required that achieve less invasive implantation methods while maintaining high spatial resolution. An endovascular stent electrode array avoids direct brain trauma and is able to record electrocorticography in local cortical tissue from within the venous vasculature...
April 28, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28425137/three-dimensional-printing-an-aid-to-epidural-access-for-neuromodulation
#17
Murray G Taverner, John P Monagle
OBJECTIVE: The case report details to use of three-dimensional (3D) printing as an aid to neuromodulation. METHODS: A patient is described in whom previous attempts at spinal neuromodulation had failed due to lack of epidural or intrathecal access, and the use of a 3D printed model allowed for improved planning and ultimately, success. RESULTS: Successful spinal cord stimulation was achieved with the plan developed by access to a 3D model of the patient's spine...
April 20, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#18
Peter S 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...
July 15, 2017: Spine
https://www.readbyqxmd.com/read/28399549/cost-effectiveness-data-regarding-spinal-cord-stimulation-for-low-back-pain
#19
Christian Hoelscher, Jonathan Riley, Chengyuan Wu, Ashwini Sharan
STUDY DESIGN: Review of published literature pertaining to spinal cord stimulation (SCS) cost data analysis. OBJECTIVE: To acquire, organize, and succinctly summarize the available literature regarding the costs associated with, and the cost-effectiveness of, SCS. 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. The traditional standard medical management with or without intermittent surgical decompression/fusion has been plagued by high costs and inconsistent results, leading to poor patient satisfaction and functional outcome, and questions from policy makers regarding use of limited healthcare resources...
July 15, 2017: Spine
https://www.readbyqxmd.com/read/28385196/enabling-task-specific-volitional-motor-functions-via-spinal-cord-neuromodulation-in-a-human-with-paraplegia
#20
Peter J Grahn, Igor A Lavrov, Dimitry G Sayenko, Meegan G Van Straaten, Megan L Gill, Jeffrey A Strommen, Jonathan S Calvert, Dina I Drubach, Lisa A Beck, Margaux B Linde, Andrew R Thoreson, Cesar Lopez, Aldo A Mendez, Parag N Gad, Yury P Gerasimenko, V Reggie Edgerton, Kristin D Zhao, Kendall H Lee
We report a case of chronic traumatic paraplegia in which epidural electrical stimulation (EES) of the lumbosacral spinal cord enabled (1) volitional control of task-specific muscle activity, (2) volitional control of rhythmic muscle activity to produce steplike movements while side-lying, (3) independent standing, and (4) while in a vertical position with body weight partially supported, voluntary control of steplike movements and rhythmic muscle activity. This is the first time that the application of EES enabled all of these tasks in the same patient within the first 2 weeks (8 stimulation sessions total) of EES therapy...
April 2017: Mayo Clinic Proceedings
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