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Dorsal column stimulation

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https://www.readbyqxmd.com/read/28370724/clinical-paresthesia-atlas-illustrates-likelihood-of-coverage-based-on-spinal-cord-stimulator-electrode-location
#1
Alexander Taghva, Edward Karst, Paul Underwood
OBJECTIVE: Concordant paresthesia coverage is an independent predictor of pain relief following spinal cord stimulation (SCS). Using aggregate data, our objective is to produce a map of paresthesia coverage as a function of electrode location in SCS. METHODS: This retrospective analysis used x-rays, SCS programming data, and paresthesia coverage maps from the EMPOWER registry of SCS implants for chronic neuropathic pain. Spinal level of dorsal column stimulation was determined by x-ray adjudication and active cathodes in patient programs...
March 28, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28339540/interventional-pain-management-for-sacroiliac-tumors-in-the-oncologic-population-a-case-series-and-paradigm-approach
#2
Nathan Hutson, Joseph C Hung, Vinay Puttanniah, Eric Lis, Ilya Laufer, Amitabh Gulati
Introduction.:  Tumors invading the sacrum and/or ilium often represent incurable metastatic disease, and treatment is targeted toward palliation of symptoms and control of pain. As systemic opioid therapy is frequently inadequate and limited by side effects, a variety of interventional techniques are available to better optimize analgesia. Using six patients as a paradigm for interventional approaches to pain relief, we present a therapeutic algorithm for treating sacroiliac tumor-related pain in the oncologic population...
October 7, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28334499/dorsal-column-stimulation-versus-dorsal-root-ganglion-stimulation-for-complex-regional-pain-syndrome-confined-to-the-knee-patients-preference-following-the-trial-period
#3
Catelijne M van Bussel, Dirk L Stronks, Frank J P M Huygen
BACKGROUND AND OBJECTIVES: Patients with complex regional pain syndrome (CRPS) confined to the knee are often therapy resistant. Neurostimulation is an accepted treatment for CRPS. Although results with dorsal column (DC) stimulation in patients with CRPS confined to the knee are often disappointing, the availability of dorsal root ganglion (DRG) stimulation may provide new opportunities for this complaint. Therefore, this study explores patients' preference for DC stimulation vs. DRG stimulation in treating chronic pain due to CRPS confined to the knee...
March 23, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28333372/characterisation-and-functional-mapping-of-surface-potentials-in-the-rat-dorsal-column-nuclei
#4
Alastair J Loutit, Ted Maddess, Stephen J Redmond, John W Morley, Greg J Stuart, Jason R Potas
The brainstem dorsal column nuclei (DCN) play a role in early processing of somatosensory information arising from a variety of functionally distinct peripheral structures, before being transmitted to the cortex via the thalamus. To improve our understanding of how sensory information is represented by the DCN, we characterised and mapped low- (<200 Hz) and high-frequency (550-3300 Hz) components of nerve-evoked DCN surface potentials. DCN surface potentials were evoked by electrical stimulation of the left and right nerves innervating cutaneous (sural nerve), or a mix of cutaneous and deep structures (peroneal nerve), in 8 week-old urethane anaesthetised male Wistar rats...
March 23, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28161015/-electrophysiological-testing-in-spinal-cord-tumors
#5
REVIEW
N André-Obadia, F Mauguière
Evoked potentials (EPs) are useful to evaluate the functional impairment of motor and somatosensory pathways in spinal cord tumors. Conduction through pyramidal tracts is evaluated by motor EPs (MEPs) elicited by transcranial stimulation, magnetic for awake patients or electric in the operating room. Somatosensory EPs (SEPs) and laser EPs (LEPs) are complementary procedures to explore conduction in dorsal columns and spinothalamic tracts, respectively. MEPs as well as SEPs show conduction abnormalities in about 60% of cases with a sensitivity that increases up to 70% when both procedures are carried out...
February 1, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28160397/alternate-intraspinal-targets-for-spinal-cord-stimulation-a-systematic-review
#6
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...
February 3, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28107590/endocannabinoid-activation-of-cb1-receptors-contributes-to-long-lasting-reversal-of-neuropathic-pain-by-repetitive-spinal-cord-stimulation
#7
L Sun, L Tai, Q Qiu, R Mitchell, S Fleetwood-Walker, E A Joosten, C W Cheung
BACKGROUND: Spinal cord stimulation (SCS) has been shown to be effective in the management of certain neuropathic pain conditions, however, the underlying mechanisms are incompletely understood. In this study, we investigated repetitive SCS in a rodent neuropathic pain model, revealing long-lasting and incremental attenuation of hyperalgesia and a mechanism of action involving endocannabinoids. METHOD: Animals were implanted with monopolar electrodes at the time of partial sciatic nerve injury...
May 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28030470/dorsal-root-ganglion-stimulation-yielded-higher-treatment-success-rate-for-complex-regional-pain-syndrome-and-causalgia-at-3-and-12-months-a-randomized-comparative-trial
#8
Timothy R Deer, Robert M Levy, Jeffery Kramer, Lawrence Poree, Kasra Amirdelfan, Eric Grigsby, Peter Staats, Allen W Burton, Abram H Burgher, Jon Obray, James Scowcroft, Stan Golovac, Leonardo Kapural, Richard Paicius, Christopher Kim, Jason Pope, Thomas Yearwood, Sam Samuel, W Porter McRoberts, Hazmer Cassim, Mark Netherton, Nathan Miller, Michael Schaufele, Edward Tavel, Timothy Davis, Kristina Davis, Linda Johnson, Nagy Mekhail
Animal and human studies indicate that electrical stimulation of dorsal root ganglion (DRG) neurons may modulate neuropathic pain signals. ACCURATE, a pivotal, prospective, multicenter, randomized comparative effectiveness trial, was conducted in 152 subjects diagnosed with complex regional pain syndrome or causalgia in the lower extremities. Subjects received neurostimulation of the DRG or dorsal column (spinal cord stimulation, SCS). The primary end point was a composite of safety and efficacy at 3 months, and subjects were assessed through 12 months for long-term outcomes and adverse events...
April 2017: Pain
https://www.readbyqxmd.com/read/27834648/epidural-stimulation-of-rat-spinal-cord-at-lumbosacral-segment-using-a-surface-electrode-a-computer-simulation-study
#9
Qi Xu, Li Kong, Hui Zhou, Jiping He
Clinical research indicates that the epidural spinal cord stimulation (ESCS) at lumbosacral segment has shown potential for promoting locomotor recovery in patients with incomplete spinal cord injury. However, the underlying neural mechanism needs to be determined by animal experiments. In order to refine experimental protocols, we used a finite element simulation to investigate the activation of nerve fibers in a rat spinal cord model. Our model is composed of a volume conductor model from L1 to S2 spinal segments and the McIntyre-Richard-Grill axon model, which is used to investigate the threshold of selected spinal fibers with different diameters at varied locations and predict the neural responses of any target fibers with bipolar electrode configuration...
November 4, 2016: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/27760823/modulation-of-activity-and-conduction-in-single-dorsal-column-axons-by-kilohertz-frequency-spinal-cord-stimulation
#10
Nathan D Crosby, John J Janik, Warren M Grill
Kilohertz-frequency spinal cord stimulation (KHF-SCS) is a potential paresthesia-free treatment for chronic pain. However, the effects of KHF-SCS on spinal dorsal column (DC) axons and its mechanisms of action remain unknown. The objectives of this study were to quantify activation and conduction block of DC axons by KHF-SCS across a range of frequencies (1, 5, 10, or 20 kHz) and waveforms (biphasic pulses or sinusoids). Custom platinum electrodes delivered SCS to the T10/T11 dorsal columns of anesthetized male Sprague-Dawley rats...
January 1, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/27744081/comparison-of-clinical-efficacy-and-computed-tomographic-analysis-of-lead-position-between-three-column-and-five-column-paddle-leads-spinal-cord-stimulation-for-failed-back-surgery-syndrome
#11
Jin-Gyu Choi, Sang-Woo Ha, Byung-Chul Son
OBJECTIVE: To investigate the difference in clinical outcome and the position of paddle lead spinal cord stimulation (SCS) between 3-column and 5-column paddle lead SCS in patients with failed back surgery syndrome. METHODS: In 21 patients who underwent paddle lead SCS at T9 (3-column, n = 9; 5-column, n =12) for failed back surgery syndrome, a 12-month follow-up numerical rating scale, percent pain relief, and computed tomography assessment of contact angle and percent reduction of T9 canal area were investigated...
January 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27699211/altered-spatiotemporal-dynamics-of-cortical-activation-to-tactile-stimuli-in-somatosensory-area-3b-and-area-1-of-monkeys-after-spinal-cord-injury
#12
Ruiqi Wu, Langting Su, Pai-Feng Yang, Li Min Chen
Reactivation of deafferented cortex plays a key role in mediating the recovery of lost functions, although the precise mechanism is not fully understood. This study simultaneously characterized the dynamic spatiotemporal features of tactile responses in areas 3b and 1 before and 6-8 weeks after partial dorsal column lesion (DCL), and examined how the reactivation relates to the recovery of simple hand use in squirrel monkeys. A combination of high spatiotemporal resolution functional intrinsic optical imaging, microelectrode mapping, behavioral assessment, and tracer histology methods were used...
September 2016: ENeuro
https://www.readbyqxmd.com/read/27689422/intraoperative-electrophysiological-monitoring-for-c1-2-spinal-cord-stimulation
#13
Laura M Muncie, Nathaniel R Ellens, Emeline Tolod-Kemp, Claudio A Feler, John S Winestone
OBJECTIVE This study is a retrospective case series involving C1-2 spinal cord stimulation in patients with complex regional pain syndrome (CRPS) under general endotracheal anesthesia. Currently, C1-2 paddle lead placement is an accepted practice, which provides effective cervical stimulation to ameliorate upper-extremity and sometimes lower-extremity symptoms experienced by patients with CRPS. However, this technique must be performed under general endotracheal anesthesia rather than in an awake or semiconscious state due to intraoperative safety concerns and patient comfort...
February 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27672531/late-spontaneous-migration-of-a-dorsal-column-stimulator-paddle-lead
#14
Chao Li, Michael A Galgano, David A Carter
The most frequently encountered complication of dorsal column stimulators is lead migration. The vast majority of these events are seen in the first few weeks to months. Late paddle lead migration is a very uncommon occurrence in this setting. We describe a case of a 51-year-old male with a history of reflex sympathetic dystrophy having undergone dorsal column stimulator insertion at the level of C1-C2. A good clinical benefit was appreciated in the postoperative period once the stimulator was turned on. Approximately six months postoperatively, the patient suddenly lost coverage...
August 17, 2016: Curēus
https://www.readbyqxmd.com/read/27658771/current-experience-of-spinal-neuromodulation-in-chronic-pain-is-there-a-role-in-children-and-young-people
#15
REVIEW
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...
January 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/27616344/5-hydroxytryptamine2a-2c-receptors-of-nucleus-raphe-magnus-and-gigantocellularis-paragigantocellularis-pars-%C3%AE-reticular-nuclei-modulate-the-unconditioned-fear-induced-antinociception-evoked-by-electrical-stimulation-of-deep-layers-of-the-superior-colliculus
#16
Ricardo de Oliveira, Rithiele Cristina de Oliveira, Luiz Luciano Falconi-Sobrinho, Raimundo da Silva Soares, Norberto Cysne Coimbra
The electrical stimulation of the dorsolateral columns of the periaquedutal grey matter (dlPAG) or deep layers of the superior colliculus (dlSC) evokes defensive behaviours followed by an antinociceptive response. Monoaminergic brainstem reticular nuclei are suggested to comprise the endogenous pain modulatory system. The aim of the present work was to investigate the role played by 5-HT2 subfamily of serotonergic receptors of the nucleus raphe magnus (NRM) and the gigantocellularis/paragigantocellularis pars α reticular nuclei (Gi/PGiα) in the elaboration of instinctive fear-induced antinociception elicited by electrical stimulation of dlPAG or of dlSC...
January 1, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/27605389/a-closed-loop-brain-machine-interface-for-epilepsy-control-using-dorsal-column-electrical-stimulation
#17
Miguel Pais-Vieira, Amol P Yadav, Derek Moreira, David Guggenmos, Amílcar Santos, Mikhail Lebedev, Miguel A L Nicolelis
Although electrical neurostimulation has been proposed as an alternative treatment for drug-resistant cases of epilepsy, current procedures such as deep brain stimulation, vagus, and trigeminal nerve stimulation are effective only in a fraction of the patients. Here we demonstrate a closed loop brain-machine interface that delivers electrical stimulation to the dorsal column (DCS) of the spinal cord to suppress epileptic seizures. Rats were implanted with cortical recording microelectrodes and spinal cord stimulating electrodes, and then injected with pentylenetetrazole to induce seizures...
September 8, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27570822/axonal-localization-of-integrins-in-the-cns-is-neuronal-type-and-age-dependent
#18
Melissa R Andrews, Sara Soleman, Menghon Cheah, David A Tumbarello, Matthew R J Mason, Elizabeth Moloney, Joost Verhaagen, Jean-Charles Bensadoun, Bernard Schneider, Patrick Aebischer, James W Fawcett
The regenerative ability of CNS axons decreases with age, however, this ability remains largely intact in PNS axons throughout adulthood. These differences are likely to correspond with age-related silencing of proteins necessary for axon growth and elongation. In previous studies, it has been shown that reintroduction of the α9 integrin subunit (tenascin-C receptor, α9) that is downregulated in adult CNS can improve neurite outgrowth and sensory axon regeneration after a dorsal rhizotomy or a dorsal column crush spinal cord lesion...
July 2016: ENeuro
https://www.readbyqxmd.com/read/27523450/spatiotemporal-trajectories-of-reactivation-of-somatosensory-cortex-by-direct-and-secondary-pathways-after-dorsal-column-lesions-in-squirrel-monkeys
#19
Hui-Xin Qi, Feng Wang, Chia-Chi Liao, Robert M Friedman, Chaohui Tang, Jon H Kaas, Malcolm J Avison
After lesions of the somatosensory dorsal column (DC) pathway, the cortical hand representation can become unresponsive to tactile stimuli, but considerable responsiveness returns over weeks of post-lesion recovery. The reactivation suggests that preserved subthreshold sensory inputs become potentiated and axon sprouting occurs over time to mediate recovery. Here, we studied the recovery process in 3 squirrel monkeys, using high-resolution cerebral blood volume-based functional magnetic resonance imaging (CBV-fMRI) mapping of contralateral somatosensory cortex responsiveness to stimulation of distal finger pads with low and high level electrocutaneous stimulation (ES) before and 2, 4, and 6weeks after a mid-cervical level contralateral DC lesion...
November 15, 2016: NeuroImage
https://www.readbyqxmd.com/read/27476516/recent-advances-in-spinal-cord-stimulation-for-pain-treatment
#20
Ganesan Baranidharan, John Titterington
Traditional (40-50 Hz) spinal column stimulation is an efficacious and widely accepted treatment for chronic neuropathic pain conditions. However, there are major challenges including its ineffectiveness for axial back pain, the burden of paresthesia-related discomfort and difficulties producing indisputable research. Recently, there have been the major technological innovations of high-frequency and burst stimulation. Studies have shown these to provide improved analgesia even for axial pain without the problems associated with paresthesia...
November 2016: Pain Management
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