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Spinal neuromodulation

S Haas, C Brock, K Krogh, M Gram, L Lundby, A M Drewes, S Laurberg
BACKGROUND: It has been suggested that the effects of sacral nerve stimulation against fecal incontinence involve neuromodulation at spinal or supraspinal levels. OBJECTIVE: This study aims to investigate the afferent sensory pathways from the anorectum before and during sacral nerve stimulation. DESIGN: This is an explorative study. PATIENTS: Fifteen women with idiopathic fecal incontinence (mean age, 58 ± 12.2 years) were selected...
November 2016: Diseases of the Colon and Rectum
Xuewen Jiang, Thomas W Fuller, Jathin Bandari, Utsav Bansal, Zhaocun Zhang, Bing Shen, Jicheng Wang, James R Roppolo, William C de Groat, Changfeng Tai
In α-chloralose anesthetized cats, we examined the role GABAA, glycine, and opioid receptors in sacral neuromodulation-induced inhibition of bladder overactivity elicited by intravesical infusion of 0.5% acetic acid (AA). AA irritation significantly (p<0.01) reduced bladder capacity to 59.5±4.8% of saline control. S1 or S2 dorsal root stimulation at threshold intensity for inducing reflex twitching of the anal sphincter or toe significantly (p<0.01) increased bladder capacity to 105.3±9.0% and 134...
October 11, 2016: Journal of Pharmacology and Experimental Therapeutics
Sandra M Garraway, J Russell Huie
Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophic factor family of signaling molecules. Since its discovery over three decades ago, BDNF has been identified as an important regulator of neuronal development, synaptic transmission, and cellular and synaptic plasticity and has been shown to function in the formation and maintenance of certain forms of memory. Neural plasticity that underlies learning and memory in the hippocampus shares distinct characteristics with spinal cord nociceptive plasticity...
2016: Neural Plasticity
N Kriek, J G Groeneweg, D L Stronks, D de Ridder, F J P M Huygen
BACKGROUND: Conventional tonic spinal cord stimulation (SCS) is an effective treatment for patients with therapy-resistant complex regional pain syndrome (CRPS). Although the therapeutic effect of SCS can diminish over time due to tolerance, pain control can be regained by changing the pulse width and the amplitude and/or by increasing the stimulation frequency. This multicentre, double-blind, randomized and placebo-controlled crossover trial was conducted to investigate whether more effective pain reduction is achieved with different frequencies (trial registration, current controlled trials, ISRCTN 36655259)...
October 7, 2016: European Journal of Pain: EJP
Débora Lanznaster, Tharine Dal-Cim, Tetsadê C B Piermartiri, Carla I Tasca
Guanosine is a purine nucleoside with important functions in cell metabolism and a protective role in response to degenerative diseases or injury. The past decade has seen major advances in identifying the modulatory role of extracellular action of guanosine in the central nervous system (CNS). Evidence from rodent and cell models show a number of neurotrophic and neuroprotective effects of guanosine preventing deleterious consequences of seizures, spinal cord injury, pain, mood disorders and aging-related diseases, such as ischemia, Parkinson's and Alzheimer's diseases...
October 2016: Aging and Disease
Thomas M Langer, Suzanne E Neumueller, Emma Crumley, Nicholas J Burgraff, Sawan Talwar, Matthew Robert Hodges, Lawrence G Pan, Hubert V Forster
Unilateral dialysis of the broad spectrum muscarinic receptor antagonist atropine (50 mM) into the ventral respiratory column (VRC; including the pre-Bӧtzinger Complex region) of awake goats increased pulmonary ventilation (V̇I) and breathing frequency (f), conceivably due to local compensatory increases in serotonin (5-HT) and substance P (SP) measured in effluent mock cerebral spinal fluid (mCSF). In contrast, unilateral dialysis of a triple cocktail of antagonists to muscarinic (atropine; 5 mM), neurokinin-1 (NK-1) and 5-HT2A receptors does not alter V̇I or f, but increases local SP...
September 29, 2016: Journal of Applied Physiology
Yann Le Déan, Benjamin Brissebrat, Evelyne Castel-Lacanal, Xavier De Boissezon, Philippe Marque
OBJECTIVE: Central neuropathic pain is common among neurological patients. Drug therapy has high pharmacoresistance and some GABAergic agents can be detrimental to the recovery process. Alternative therapies include neuromodulation techniques, such as repetitive transcranial magnetic stimulation (rTMS) and motor imagery techniques with mirror therapy. The objective of this study was to evaluate their effectiveness in clinical practice on central neuropathic pain. MATERIAL/PATIENTS AND METHODS: Thirty-two patients followed in the Physical Medicine and Rehabilitation department of Rangueil University Hospital were included...
September 2016: Annals of Physical and Rehabilitation Medicine
David Pang
INTRODUCTION: Chronic pain in children has been an under-recognized problem compared to adult pain. The aim of management is to help children and their families cope with the symptoms rather than a cure. Current medical treatments to reduce pain intensity are often short lived, poorly tolerated or ineffective. RESULTS: The use of electrical stimulation to treat pain is the current basis of modern Neuromodulation at the spinal cord and has been well established as spinal cord stimulation in adult practice...
August 9, 2016: European Journal of Paediatric Neurology: EJPN
Le Zhang, Gongming Wang, Jinben Ma, Chengxiao Liu, Xijiang Liu, Yufeng Zhan, Mengyuan Zhang
The rostral anterior cingulate cortex (rACC) plays an important role in pain affect. Previous investigations have reported that the rACC mediates the negative affective component of inflammatory pain and contributed to the aversive state of nerve injury-induced neuropathic pain. Brain-derived neurotrophic factor (BDNF), an activity-dependent neuromodulator in the adult brain, is believed to play a role in the development and maintenance of inflammatory and neuropathic pain in the spinal cord. However, whether and how BDNF in the rACC regulates pain-related aversion due to peripheral nerve injury is largely unknown...
August 27, 2016: Brain Research Bulletin
V Tronnier
Unfortunately, 10-40 % of patients still experience pain after spinal surgery. There are many reasons for the patients' complaints. If no identifiable cause, such as a recurrent disc herniation, is visible, this is referred to as failed back surgery syndrome. However, this definition includes a variety of possible underlying causes of the pain, which result in just as many different therapeutic approaches. In addition to pharmacological, behavioral and physical therapy, also neuromodulation techniques can be offered; the best known method is spinal cord stimulation (SCS)...
September 2016: Der Orthopäde
Mary E Donhoffner, Sydney P Goings, Korosh Atabaki, Ruth I Wood
Oxytocin (OT) is a neuromodulator that facilitates pair-bonding, maternal care, and social approach. OT is thought to promote these social behaviors by enhancing the salience and reinforcing effects of relevant social stimuli. There is the additional possibility that OT per se may be rewarding. To test this, we investigated whether female rats would voluntarily self-administer OT. Female Long-Evans rats were ovariectomized, and received an estrogen implant and an intracerebroventricular cannula. Rats were tested in an operant chamber with active and inactive levers...
August 16, 2016: Journal of Neuroendocrinology
Mirnela Byku, Douglas L Mann
Sympathovagal imbalance contributes to progressive worsening of HF (HF) and is associated with untoward clinical outcomes. Based on compelling pre-clinical studies which supported the role of autonomic modulation in HF models, a series of clinical studies were initiated using spinal cord stimulation (SCS), vagus nerve stimulation (VNS) and baroreceptor activation therapy (BAT) in patients with HF with a reduced ejection fraction (HFrEF). While the phase II studies with BAT remain encouraging, the larger clinical studies with SCS and VNS have yielded disappointing results...
April 2016: JACC. Basic to Translational Science
Anne-Li Lind, Payam Emami Khoonsari, Marcus Sjödin, Lenka Katila, Magnus Wetterhall, Torsten Gordh, Kim Kultima
OBJECTIVES: Electrical neuromodulation by spinal cord stimulation (SCS) is a well-established method for treatment of neuropathic pain. However, the mechanism behind the pain relieving effect in patients remains largely unknown. In this study, we target the human cerebrospinal fluid (CSF) proteome, a little investigated aspect of SCS mechanism of action. METHODS: Two different proteomic mass spectrometry protocols were used to analyze the CSF of 14 SCS responsive neuropathic pain patients...
August 2016: Neuromodulation: Journal of the International Neuromodulation Society
H Nechutova, M Soucek, K Brabencova, R Stepanova, M Blaha, J Vanicek
OBJECTIVE: In our study, we focus on particular brain neurons and their axonal connections within the brainstem and spinal cord, which regulate the sympathetic and parasympathetic nerves[Combining Acute Accent] functions, involved in the regulation of blood pressure. Processes of neuromodulation are mentioned to take place within these neural connections of central nervous system. The target group for analysis is represented by patients with hypertension. DESIGN AND METHOD: We analysed the descending nervous fascicle in patients with hypertension and in healthy controls...
September 2016: Journal of Hypertension
Christophe Perruchoud, Nicolas Mariotti
Neuromodulation techniques modify the activity of the central or peripheral nervous system. Spinal cord stimulation is a reversible and minimally invasive treatment whose efficacy and cost effectiveness are recognized for the treatment of chronic neuropathic pain or ischemic pain. Spinal cord stimulation is not the option of last resort and should be considered among other options before prescribing long-term opioids or considering reoperation. The selection and regular follow-up of patients are crucial to the success of the therapy...
June 22, 2016: Revue Médicale Suisse
A Sierakowski, S S Jing, J Poel, D Elliot
BACKGROUND: A small number of patients develop intractable peripheral nerve pain following injury or surgery to the upper limb that is refractory to pharmacological treatment. This study reports our results of using transcutaneous peripheral nerve stimulation (TPNS), a non-invasive form of neuromodulation, to treat this difficult problem. METHODS: Seventy-two patients were treated for intractable pain in the upper limb using this technique. Electrical current was delivered transcutaneously through a handheld probe, placed on the skin overlying the affected peripheral nerve proximal to the site of pain...
February 2016: J Hand Surg Asian Pac Vol
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
William Stuart Reynolds, Elizabeth Timbrook Brown, Jill Danford, Melissa Kaufman, Alan Wein, Roger Dmochowski, Stephen Bruehl
INTRODUCTION: This study sought to provide a preliminary assessment of whether spinally mediated afferent hyperactivity (i.e., central sensitization) might contribute to manifestations of overactive bladder syndrome (OAB) in women as indexed by elevated temporal summation of evoked heat pain stimuli. METHODS: We recruited 20 adult women with OAB who were planning to undergo interventional therapy for OAB with either onabotulinumtoxinA injection or sacral neuromodulation and 23 healthy controls without OAB symptoms to undergo quantitative sensory testing with cutaneous thermal pain temporal summation...
July 19, 2016: Neurourology and Urodynamics
John S Thornton
PURPOSE: This review summarises the need for MRI with in situ neuromodulation, the key safety challenges and how they may be mitigated, and surveys the current status of MRI safety for the main categories of neuro-stimulation device, including deep brain stimulation, vagus nerve stimulation, sacral neuromodulation, spinal cord stimulation systems, and cochlear implants. REVIEW SUMMARY: When neuro-stimulator systems are introduced into the MRI environment a number of hazards arise with potential for patient harm, in particular the risk of thermal injury due to MRI-induced heating...
June 20, 2016: European Journal of Paediatric Neurology: EJPN
Yoshiki Ogata, Wataru Nemoto, Osamu Nakagawasai, Ryota Yamagata, Takeshi Tadano, Koichi Tan-No
Renin-angiotensin system (RAS) activity increases under hyperglycemic states, and is thought to be involved in diabetic complications. We previously demonstrated that angiotensin (Ang) II, a main bioactive component of the RAS, might act as a neurotransmitter and/or neuromodulator in the transmission of nociceptive information in the spinal cord. Here, we examined whether the spinal Ang II system is responsible for diabetic neuropathic pain induced by streptozotocin (STZ). Tactile allodynia was observed concurrently with an increase in blood glucose levels the day after mice received STZ (200 mg/kg, i...
September 2016: Molecular Pharmacology
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