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Spinal neuromodulation

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https://www.readbyqxmd.com/read/29289565/artifactual-hyperpolarization-during-extracellular-electrical-stimulation-proposed-mechanism-of-high-rate-neuromodulation-disproved
#1
L Stephen Lesperance, Milad Lankarany, Tianhe C Zhang, Rosana Esteller, Stéphanie Ratté, Steven A Prescott
BACKGROUND: Kilohertz-frequency electric field stimulation (kEFS) applied to the spinal cord can reduce chronic pain without causing the buzzing sensation (paresthesia) associated with activation of dorsal column fibers. This suggests that high-rate spinal cord stimulation (SCS) has a mode of action distinct from conventional, parasthesia-based SCS. A recent study reported that kEFS hyperpolarizes spinal neurons, yet this potentially transformative mode of action contradicts previous evidence that kEFS induces depolarization and was based on patch clamp recordings whose accuracy in the presence of kEFS has not been verified...
December 15, 2017: Brain Stimulation
https://www.readbyqxmd.com/read/29249191/burst-and-high-frequency-stimulation-underlying-mechanism-of-action
#2
Shaheen Ahmed, Thomas Yearwood, Dirk De Ridder, Sven Vanneste
Paresthesia-free spinal cord stimulation (SCS) techniques, such as burst and high-frequency (HF) SCS, have been developed and demonstrated to be successful for treating chronic pain, albeit via different mechanisms of action. The goal of this review is to discuss the mechanisms of action for pain suppression at both the cellular and systems levels for burst and HF SCS. In addition, we also discuss the neuromodulation devices that mimic these paradigms. Areas covered: The authors performed a literature review to unravel the mechanisms of action for burst and HF SCS coupled with booklets and user manuals from neuromodulation companies to understand the programmable parameters and operating ranges...
January 2018: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29244102/association-of-opioid-usage-with-spinal-cord-stimulation-outcomes
#3
Ashwini D Sharan, Jonathan Riley, Steven Falowski, Jason E Pope, Allison T Connolly, Edward Karst, Nirav Dalal, David A Provenzano
Study Design: Observational study using insurance claims. Objective: To quantify opioid usage leading up to spinal cord stimulation (SCS) and the potential impact on outcomes of SCS. Setting: SCS is an interventional therapy that often follows opioid usage in the care continuum for chronic pain. Methods: This study identified SCS patients using the Truven Health MarketScan databases from January 2010 to December 2014...
December 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29204381/a-fuzzy-controller-for-movement-stabilization-using-afferent-control-controller-synthesis-and-simulation
#4
Zahra Khodadadi, Hamid R Kobravi, Milad F Majd
Stimulation of spinal sensorimotor circuits can improve motor control in animal models and humans with spinal cord injury (SCI). More recent evidence suggests that the stimulation increases the level of excitability in the spinal circuits, activates central pattern generators, and it is also able to recruit distinctive afferent pathways connected to specific sensorimotor circuits. In addition, the stimulation generates well-defined responses in leg muscles after each pulse. The problem is that in most of the neuromodulation devices, electrical stimulation parameters are regulated manually and stay constant during movement...
October 2017: Journal of Medical Signals and Sensors
https://www.readbyqxmd.com/read/29196322/a-new-high-efficacy-non-invasive-transcranial-electric-stimulation-tuned-to-local-neurodynamics
#5
Carlo Cottone, Andrea Cancelli, Patrizio Pasqualetti, Camillo Porcaro, Carlo Salustri, Franca Tecchio
In this paper, we pose the following working hypothesis: in humans, transcranial electric stimulation (tES) with a time course that mimics the endogenous activity of its target is capable of altering the target's excitability. In our case, the target was the primary motor cortex (M1). We identified the endogenous neurodynamics of hand M1's subgroups of pyramidal neuronal pools in each of our subjects by applying Functional Source Separation (FSS) to their electroencephalographic (EEG) recordings. We then tested whether the cortico-spinal excitability of the hand representation under the above described stimulation, which we named transcranial Individual neuroDynamics Stimulation (tIDS), was higher than in the absence of stimulation (baseline)...
December 1, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29186582/safety-of-spinal-cord-stimulation-in-patients-who-routinely-use-anticoagulants
#6
Hirah Khan, Vignessh Kumar, Zohal Ghulam-Jelani, Sarah E McCallum, Ellie Hobson, Vishad Sukul, Julie G Pilitsis
Objective: We assess the safety of performing the epidural placement or revision of spinal cord stimulation (SCS) in patients whose anticoagulation has been held (termed "anticoagulant-suspended" patients) in accordance with the 2017 Neurostimulation Appropriateness Consensus Committee (NACC) guidelines. Subjects: Patients undergoing SCS were included in this institutional review board-approved study. Design: A retrospective analysis of a prospectively collected database was performed...
November 27, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29142093/developmental-changes-in-spinal-neuronal-properties-motor-network-configuration-and-neuromodulation-at-free-swimming-stages-of-xenopus-frog-tadpoles
#7
Stephen Paul Currie, Keith Thomas Sillar
We describe a novel preparation of the isolated brainstem and spinal cord from pro-metamorphic tadpole stages of the South African clawed frog (Xenopus laevis) that permits whole cell patch-clamp recordings from neurons in the ventral spinal cord. Previous research on earlier stages of the same species has provided one of the most detailed understandings of the design and operation of a CPG circuit. Here we have addressed how development sculpts complexity from this more basic circuit. The preparation generates bouts of fictive swimming activity either spontaneously or in response to electrical stimulation of the optic tectum, allowing an investigation into how the neuronal properties, activity patterns and neuromodulation of locomotor rhythm generation change during development...
November 15, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29138092/abnormal-cortical-neuroplasticity-induced-by-paired-associative-stimulation-after-traumatic-spinal-cord-injury-a-preliminary-study
#8
Viviana Versace, Patrick B Langthaler, Yvonne Höller, Vanessa N Frey, Francesco Brigo, Luca Sebastianelli, Leopold Saltuari, Raffaele Nardone
We aimed at assessing in this pilot study whether patients with spinal cord injury (SCI) show alterations of sensorimotor plasticity within the primary motor cortex (M1). Since learning in human M1 occurs through LTP-like mechanisms, we employed the paired associative stimulation (PAS) protocol by transcranial magnetic stimulation (TMS), which is able to induce LTP-like effects in M1, in subjects with chronic SCI. We found that PAS protocol significantly increased corticospinal excitability as long as 30minutes in healthy subjects and in SCI patients with good motor recovery, while it was followed by a non-significant increase of MEP amplitude in the SCI patients with poor functional recovery...
November 11, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/29115915/neuromodulation-in-multiple-sclerosis
#9
Hesham Abboud, Eddie Hill, Junaid Siddiqui, Alessandro Serra, Benjamin Walter
Neuromodulation, or the utilization of advanced technology for targeted electrical or chemical neuronal stimulation or inhibition, has been expanding in several neurological subspecialties. In the past decades, immune-modulating therapy has been the main focus of multiple sclerosis (MS) research with little attention to neuromodulation. However, with the recent advances in disease-modifying therapies, it is time to shift the focus of MS research to neuromodulation and restoration of function as with other neurological subspecialties...
November 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/29102670/and-yet-it-moves-recovery-of-volitional-control-after-spinal-cord-injury
#10
REVIEW
G Taccola, D Sayenko, P Gad, Y Gerasimenko, V R Edgerton
Preclinical and clinical neurophysiological and neurorehabilitation research has generated rather surprising levels of recovery of volitional sensory-motor function in persons with chronic motor paralysis following a spinal cord injury. The key factor in this recovery is largely activity-dependent plasticity of spinal and supraspinal networks. This key factor can be triggered by neuromodulation of these networks with electrical and pharmacological interventions. This review addresses some of the systems-level physiological mechanisms that might explain the effects of electrical modulation and how repetitive training facilitates the recovery of volitional motor control...
January 2018: Progress in Neurobiology
https://www.readbyqxmd.com/read/29075183/the-role-of-functional-neuroanatomy-of-the-lumbar-spinal-cord-in-effect-of-epidural-stimulation
#11
Carlos A Cuellar, Aldo A Mendez, Riazul Islam, Jonathan S Calvert, Peter J Grahn, Bruce Knudsen, Tuan Pham, Kendall H Lee, Igor A Lavrov
In this study, the neuroanatomy of the swine lumbar spinal cord, particularly the spatial orientation of dorsal roots was correlated to the anatomical landmarks of the lumbar spine and to the magnitude of motor evoked potentials during epidural electrical stimulation (EES). We found that the proximity of the stimulating electrode to the dorsal roots entry zone across spinal segments was a critical factor to evoke higher peak-to-peak motor responses. Positioning the electrode close to the dorsal roots produced a significantly higher impact on motor evoked responses than rostro-caudal shift of electrode from segment to segment...
2017: Frontiers in Neuroanatomy
https://www.readbyqxmd.com/read/29072810/serotonin-neuron-development-shaping-molecular-and-structural-identities
#12
REVIEW
Evan Deneris, Patricia Gaspar
The continuing fascination with serotonin (5-hydroxytryptamine, 5-HT) as a nervous system chemical messenger began with its discovery in the brains of mammals in 1953. Among the many reasons for this decades-long interest is that the small numbers of neurons that make 5-HT influence the excitability of neural circuits in nearly every region of the brain and spinal cord. A further reason is that 5-HT dysfunction has been linked to a range of psychiatric and neurological disorders many of which have a neurodevelopmental component...
October 26, 2017: Wiley Interdisciplinary Reviews. Developmental Biology
https://www.readbyqxmd.com/read/29063170/-neuromodulation-of-lower-urinary-tract-dysfunction
#13
REVIEW
T M Kessler, S de Wachter
Neuromodulative procedures such as transcutaneous electrical nerve stimulation (TENS), transcutaneous/percutaneous tibial nerve stimulation (TTNS/PTNS), and sacral neuromodulation (SNM) are promising second-line treatments for refractory lower urinary tract dysfunction. Using these therapies, both storage and voiding disorders but also bowel dysfunction might be successfully treated. Although the mechanism of action of neuromodulation is not well understood, it seems to involve modulation of spinal cord reflexes and brain networks by peripheral afferents (genital/rectal, tibial and sacral afferents in the case of TENS, TTNS/PTNS, and SNM, respectively)...
October 23, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29060062/safe-direct-current-stimulator-design-for-reduced-power-consumption-and-increased-reliability
#14
Gene Fridman
Current state of the art neural prosthetics, such as cochlear implants, spinal cord stimulators, and deep brain stimulators use implantable pulse generators (IPGs) to excite neural activity. Inhibition of neural firing is typically indirect and requires excitation of neurons that then have inhibitory projections downstream. Safe Direct Current Stimulator (SDCS) technology is designed to convert electronic pulses delivered to electrodes embedded within an implantable device to ionic direct current (iDC) at the output of the device...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29042375/non-invasive-brain-stimulation-interventions-for-management-of-chronic-central-neuropathic-pain-a-scoping-review-protocol
#15
Mei Lin Chen, Lin Yao, Jennifer Boger, Kathryn Mercer, Benjamin Thompson, Ning Jiang
INTRODUCTION: Pain can affect people regardless of age, gender or ethnicity. Chronic central neuropathic pain (CCNP) is a debilitating condition that affects populations such as stroke survivors, amputees, spinal cord injury patients and patients with multiple sclerosis, with prevalence rates between 30% and 80%. This condition can be caused by a lesion or disease affecting the somatosensory system. CCNP is notoriously drug resistant, and few effective CCNP treatment or management strategies exist...
October 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29026048/spinal-cord-stimulation-for-chronic-non-cancer-pain-a-review-of-current-evidence-and-practice
#16
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/29016994/neuromodulation-in-postherpetic-neuralgia-case-reports-and-review-of-the-literature
#17
Svetlana Kurklinsky, Scott C Palmer, Mack J Arroliga, Salim M Ghazi
Objective: Postherpetic neuralgia (PHN) is common in the United States. Current treatment options for PHN are fairly limited. Spinal cord stimulation (SCS) and peripheral nerve stimulation (PNS) are considered mostly experimental and still rarely performed in patients with PHN. Design: Two case reports and a review of the literature. Setting: Tertiary academic medical center. Methods: 1) Pubmed, Ovid, and EBMR databases were searched for all reports that had the following key words: postherpetic neuralgia, spinal cord stimulation, and peripheral nerve stimulation...
July 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28975677/sacral-neuromodulation-standardized-electrode-placement-technique
#18
Klaus E Matzel, Emmanuel Chartier-Kastler, Charles H Knowles, Paul A Lehur, Arantxa Muñoz-Duyos, Carlo Ratto, Mona B Rydningen, Michael Sørensen, Philip van Kerrebroeck, Stefan de Wachter
INTRODUCTION: Sacral neuromodulation (SNM) (sacral nerve stimulation SNS) has become an established therapy for functional disorders of the pelvic organs. Despite its overall success, the therapy fails in a proportion of patients. This may be partially due to inadequate electrode placement with suboptimal coupling of the electrode and nerve. Based on these assumptions the technique of sacral spinal neuromodulation has been redefined. All descriptions relate to the only currently available system licensed for all pelvic indications (Medtronic Interstim® )...
October 4, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28961366/success-using-neuromodulation-with-burst-sunburst-study-results-from-a-prospective-randomized-controlled-trial-using-a-novel-burst-waveform
#19
Timothy Deer, Konstantin V Slavin, Kasra Amirdelfan, Richard B North, Allen W Burton, Thomas L Yearwood, Ed Tavel, Peter Staats, Steven Falowski, Jason Pope, Rafael Justiz, Alain Y Fabi, Alexander Taghva, Richard Paicius, Timothy Houden, Derron Wilson
OBJECTIVE: The purpose of the multicenter, randomized, unblinded, crossover success using neuromodulation with BURST (SUNBURST) study was to determine the safety and efficacy of a device delivering both traditional tonic stimulation and burst stimulation to patients with chronic pain of the trunk and/or limbs. METHODS: Following a successful tonic trial, 100 subjects were randomized to receive one stimulation mode for the first 12 weeks, and then the other stimulation mode for the next 12 weeks...
September 29, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28934801/increasing-rates-of-imaging-in-failed-back-surgery-syndrome-patients-implications-for-spinal-cord-stimulation
#20
S Harrison Farber, Jing L Han, Frank W Petraglia Iii, Robert Gramer, Siyun Yang, Promila Pagadala, Beth Parente, Jichun Xie, Jeffrey R Petrella, Shivanand P Lad
BACKGROUND: Failed back surgery syndrome (FBSS) has a high incidence following spinal surgery, is notoriously refractory to treatment, and results in high health care utilization. Spinal cord stimulation (SCS) is a well-accepted modality for pain relief in this population; however, until recently magnetic resonance imaging (MRI) was prohibited due to risk of heat conduction through the device. OBJECTIVES: We examined trends in imaging use over the past decade in patients with FBSS to determine its impact on health care utilization and implications for patients receiving SCS...
September 2017: Pain Physician
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