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DRG

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165 papers 25 to 100 followers
By Xander Zuidema MD, pharmD, Anesthesiologist, intensivist, pain specialist
https://www.readbyqxmd.com/read/29131488/dorsal-root-ganglion-stimulation-used-for-the-treatment-of-chronic-neuropathic-pain-in-the-groin-a-single-center-study-with-long-term-prospective-results-in-34-cases
#1
Matthias Hubert Morgalla, Anil Bolat, Marcos Fortunato, Guilherme Lepski, Bankim Subhash Chander
OBJECTIVE: Chronic neuropathic pain in the groin is a severe condition and difficult to treat. Dorsal root ganglion stimulation (DRGS) covers discrete painful areas precisely with its stimulation power in comparison to spinal cord stimulation (SCS). It was our hypothesis that DRGS provides a long-term relief of chronic groin pain over a period of more than three years. MATERIALS AND METHODS: Patients (age >18 years) with chronic neuropathic groin pain were prospectively examined...
November 13, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28975677/sacral-neuromodulation-standardized-electrode-placement-technique
#2
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/28960653/the-efficacy-and-safety-of-dorsal-root-ganglion-stimulation-as-a-treatment-for-neuropathic-pain-a-literature-review
#3
REVIEW
Conrad Harrison, Sarah Epton, Stana Bojanic, Alexander L Green, James J FitzGerald
OBJECTIVE: Dorsal root ganglion stimulation (DRGS) received its first regulatory approval (CE marking in Europe) in late 2011, and so its use is now almost six years old. Several thousand patients have already been treated, and a landmark trial in lower limb complex regional pain syndrome (CRPS) and causalgia has recently been published. METHODS: In this review we have summarized the literature to date on the use of DRGS in the treatment of neuropathic pain. RESULTS: The results so far are encouraging, with reports of successful use in treating a wide range of indications including postsurgical pain, CRPS, and phantom pain...
September 28, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28940994/drg-spinal-cord-stimulation-as-solution-for-patients-with-severe-pain-due-to-anterior-cutaneous-nerve-entrapment-syndrome-a-case-series
#4
Frédérique Mathilde Ulrike Mol, Rudi M H Roumen
OBJECTIVES: Anterior Cutaneous Nerve Entrapment Syndrome (ACNES) is a debilitating neuropathic pain condition. A small portion of patients do not respond to any currently available treatment modalities. These patients, often young women, might benefit from targeted spinal cord stimulation of the dorsal root ganglion (DRG). METHODS: This retrospective case series describes five ACNES patients who were referred from a Dutch dedicated tertiary referral center to collaborating sites with extensive experience in DRG stimulation to be implanted with a DRG Axium System (St...
September 21, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28895256/relevant-anatomy-morphology-and-implantation-techniques-of-the-dorsal-root-ganglia-at-the-lumbar-levels
#5
Tim Vancamp, Robert M Levy, Isaac Peña, Antonio Pajuelo
OBJECTIVES: While dorsal root ganglion (DRG) stimulation has been available in Europe and Australia for the past five years and in the United States for the past year, there are no published details concerning the optimal procedures for DRG lead implantation. MATERIALS AND METHODS: We describe several techniques that can be applied to implant cylindrical leads over the DRG, highlighting some tips and tricks according to our experiences. Focus is mainly shifted toward implantations in the lumbar area...
October 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28872725/dorsal-root-ganglion-field-stimulation-prevents-inflammation-and-joint-damage-in-a-rat-model-of-rheumatoid-arthritis
#6
Bin Pan, Zhiyong Zhang, Dongman Chao, Quinn H Hogan
OBJECTIVES: Electrical stimulation of the dorsal root ganglion (DRG), referred to here as ganglionic field stimulation (GFS), is effective in reducing clinical pain, probably by interrupting transmission of afferent impulse trains on sensory neurons as they pass through the DRG. We therefore tested whether efferent impulse trains conveyed by sensory neurons, which contribute to neurogenic inflammation, may also be interrupted by GFS. MATERIALS AND METHODS: Collagen-induced arthritis, a model of clinical rheumatoid arthritis, was initiated in rats concurrently with the insertion of an electrode for GFS at the fourth lumbar DRG...
September 5, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28621025/dorsal-root-ganglion-stimulation-as-a-salvage-treatment-for-complex-regional-pain-syndrome-refractory-to-dorsal-column-spinal-cord-stimulation-a-case-series
#7
Ajax Yang, Corey W Hunter
OBJECTIVE: The efficacy of traditional spinal cord stimulation (t-SCS) tends to decay over time in patients with complex regional pain syndrome (CRPS). While it has been shown that dorsal root ganglion (DRG) stimulation is extremely effective in t-SCS-naïve patients with CRPS, its efficacy in patients who had previously failed t-SCS is unknown. Given that DRG-SCS and t-SCS target different spinal pathways, a failure with t-SCS should not automatically preclude a patient from attempting DRG-SCS...
October 2017: Neuromodulation: Journal of the International Neuromodulation Society
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/27902567/dorsal-root-ganglion-neurons-become-hyperexcitable-and-increase-expression-of-voltage-gated-t-type-calcium-channels-cav3-2-in-paclitaxel-induced-peripheral-neuropathy
#9
Yan Li, Claudio Esteves Tatsui, Laurence D Rhines, Robert Y North, Daniel S Harrison, Ryan M Cassidy, Caj A Johansson, Alyssa K Kosturakis, Denaya D Edwards, Hongmei Zhang, Patrick M Dougherty
Here, it is shown that paclitaxel-induced neuropathy is associated with the development of spontaneous activity (SA) and hyperexcitability in dorsal root ganglion (DRG) neurons that is paralleled by increased expression of low-voltage-activated calcium channels (T-type; Cav3.2). The percentage of DRG neurons showing SA and the overall mean rate of SA were significantly higher at day 7 in rats receiving paclitaxel treatment than in rats receiving vehicle. Cav3.2 expression was increased in L4-L6 DRG and spinal cord segments in paclitaxel-treated rats, localized to small calcitonin gene-related peptide and isolectin B4 expressing DRG neurons and to glial fibrillary acidic protein-positive spinal cord cells...
March 2017: Pain
https://www.readbyqxmd.com/read/27687223/dorsal-root-ganglionic-field-stimulation-relieves-spontaneous-and-induced-neuropathic-pain-in-rats
#10
Bin Pan, Hongwei Yu, Gregory J Fischer, Jeffery M Kramer, Quinn H Hogan
Dorsal root ganglion (DRG) electrical stimulation (ganglionic field stimulation [GFS]) is effective in relieving clinical pain, but its mechanism is unknown. We therefore developed a rat model for GFS to test analgesic effects in the context of neuropathic pain. GFS was applied with a bipolar electrode at L4, using parameters replicating clinical use (20 Hz, 150-μs pulse width, current at 80% of motor threshold). Neuropathic pain was generated by tibial nerve injury (TNI). Pain behavior was monitored by determining the threshold for withdrawal from punctate mechanical stimuli, by identifying hyperalgesic responses to noxious mechanical stimuli, and by hypersensitivity to cold...
December 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27483126/contribution-of-the-suppressor-of-variegation-3-9-homolog-1-in-dorsal-root-ganglia-and-spinal-cord-dorsal-horn-to-nerve-injury-induced-nociceptive-hypersensitivity
#11
Jun Zhang, Lingli Liang, Xuerong Miao, Shaogen Wu, Jing Cao, Bo Tao, Qingxiang Mao, Kai Mo, Ming Xiong, Brianna Marie Lutz, Alex Bekker, Yuan-Xiang Tao
BACKGROUND: Peripheral nerve injury-induced gene alterations in the dorsal root ganglion (DRG) and spinal cord likely participate in neuropathic pain genesis. Histone methylation gates gene expression. Whether the suppressor of variegation 3-9 homolog 1 (SUV39H1), a histone methyltransferase, contributes to nerve injury-induced nociceptive hypersensitivity is unknown. METHODS: Quantitative real-time reverse transcription polymerase chain reaction analysis, Western blot analysis, or immunohistochemistry were carried out to examine the expression of SUV39H1 mRNA and protein in rat DRG and dorsal horn and its colocalization with DRG μ-opioid receptor (MOR)...
October 2016: Anesthesiology
https://www.readbyqxmd.com/read/27224659/the-dorsal-root-ganglion-as-a-therapeutic-target-for-chronic-pain
#12
REVIEW
Liong Liem, Eric van Dongen, Frank J Huygen, Peter Staats, Jeff Kramer
Chronic neuropathic pain is a widespread problem with negative personal and societal consequences. Despite considerable clinical neuroscience research, the goal of developing effective, reliable, and durable treatments has remained elusive. The critical role played by the dorsal root ganglion (DRG) in the induction and maintenance of chronic pain has been largely overlooked in these efforts, however. It may be that, by targeting this site, robust new options for pain management will be revealed. This review summarizes recent advances in the knowledge base for DRG-targeted treatments for neuropathic pain:• Pharmacological options including the chemical targeting of voltage-dependent calcium channels, transient receptor potential channels, neurotrophin production, potentiation of opioid transduction pathways, and excitatory glutamate receptors...
July 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27125284/treatment-of-fbss-low-back-pain-with-a-novel-percutaneous-drg-wireless-stimulator-pilot-and-feasibility-study
#13
Richard L Weiner, Anthony Yeung, Carlos Montes Garcia, Laura Tyler Perryman, Benjamin Speck
OBJECTIVES: Test a miniaturized neurostimulator transforaminally placed at the dorsal root ganglion (DRG) and evaluate the device's safety and efficacy in treating failed back surgery syndrome (FBSS) low back pain. DESIGN: Pilot, two-phase study. SUBJECTS: Eleven subjects with chronic intractable neuropathic trunk and/or lower limbs pain were included. METHODS: The system consisted of an implantable, miniaturized stimulator, provided by Stimwave Technologies (Freedom-4) and an external transmitter...
October 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27059278/effect-of-burst-stimulation-evaluated-in-patients-familiar-with-spinal-cord-stimulation
#14
Marleen C Tjepkema-Cloostermans, Cecile C de Vos, Rian Wolters, Cindy Dijkstra-Scholten, Mathieu W P M Lenders
OBJECTIVE: Spinal cord stimulation (SCS) is used for treating intractable neuropathic pain. It has been suggested that burst SCS (five pulses at 500 Hz, delivered 40 times per second) suppresses neuropathic pain at least as well as conventional tonic SCS, but without evoking paraesthesia. The efficacy of paraesthesia-free high and low amplitude burst SCS for the treatment of neuropathic pain in patients who are already familiar with tonic SCS was evaluated. MATERIALS AND METHODS: Forty patients receiving conventional (30-120 Hz) tonic SCS for at least six months were included...
July 2016: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/27019220/treatment-of-neuropathic-pain-and-functional-limitations-associated-with-multiple-sclerosis-using-an-mri-compatible-spinal-cord-stimulator-a-case-report-with-two-year-follow-up-and-literature-review
#15
REVIEW
David A Provenzano, Joseph R Williams, Gaye Jarzabek, Leonard A DeRiggi, Thomas F Scott
OBJECTIVE: To report a case with two years follow-up of neuropathic pain and functional limitations associated with multiple sclerosis (MS) effectively treated with an MRI conditional spinal cord stimulator (SCS) system that allowed for spinal imaging. To present a comprehensive literature review of spinal cord stimulator utilization in the treatment of multiple sclerosis. DESIGN: Case report and literature review. INTERVENTION: Treatment was a spinal cord stimulation implant after successful trial...
June 2016: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/26990318/noninvasive-transcutaneous-vagus-nerve-stimulation-decreases-whole-blood-culture-derived-cytokines-and-chemokines-a-randomized-blinded-healthy-control-pilot-trial
#16
RANDOMIZED CONTROLLED TRIAL
Imanuel Lerman, Richard Hauger, Linda Sorkin, James Proudfoot, Bryan Davis, Andy Huang, Katie Lam, Bruce Simon, Dewleen G Baker
OBJECTIVES: The purpose of this study was to test the transcutaneous noninvasive vagus nerve stimulator (nVNS) (gammaCore©) device to determine if it modulates the peripheral immune system, as has been previously published for implanted vagus nerve stimulators. MATERIALS AND METHODS: A total of 20 healthy males and females were randomized to receive either nVNS or sham stimulation (SST). All subjects underwent an initial blood draw at 8:00 am, followed by stimulation with nVNS or SST at 8:30 am...
April 2016: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/26979998/dorsal-root-ganglion-infiltration-by-macrophages-contributes-to%C3%A2-paclitaxel-chemotherapy-induced-peripheral-neuropathy
#17
Hongmei Zhang, Yan Li, Marianna de Carvalho-Barbosa, Annemieke Kavelaars, Cobi J Heijnen, Phillip J Albrecht, Patrick M Dougherty
UNLABELLED: Chemotherapy-induced peripheral neuropathy (CIPN) is a disruptive and persistent side effect of cancer treatment with paclitaxel. Recent reports showed that paclitaxel treatment results in the activation of Toll-like receptor 4 (TLR4) signaling and increased expression of monocyte chemoattractant protein 1 (MCP-1) in dorsal root ganglion cells. In this study, we sought to determine whether an important consequence of this signaling and also a key step in the CIPN phenotype was the recruitment and infiltration of macrophages into dorsal root ganglia (DRG)...
July 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/26935254/neuropathic-low-back-pain-in-clinical-practice
#18
REVIEW
R Baron, A Binder, N Attal, R Casale, A H Dickenson, R-D Treede
BACKGROUND AND OBJECTIVE: Low back pain (LBP) is one of the most common chronic pain conditions. This paper reviews the available literature on the role of neuropathic mechanisms in chronic LBP and discusses implications for its clinical management, with a particular focus on pharmacological treatments. DATABASES AND DATA TREATMENT: Literature searches were performed in PubMed, key pain congresses and ProQuest Dialog to identify published evidence on neuropathic back pain and its management...
July 2016: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/26919608/central-sensitization-as-the-mechanism-underlying-pain-in-joint-hypermobility-syndrome-ehlers-danlos-syndrome-hypermobility-type
#19
G Di Stefano, C Celletti, R Baron, M Castori, M Di Franco, S La Cesa, C Leone, A Pepe, G Cruccu, A Truini, F Camerota
BACKGROUND: Patients with joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type (JHS/EDS-HT) commonly suffer from pain. How this hereditary connective tissue disorder causes pain remains unclear although previous studies suggested it shares similar mechanisms with neuropathic pain and fibromyalgia. METHODS: In this prospective study seeking information on the mechanisms underlying pain in patients with JHS/EDS-HT, we enrolled 27 consecutive patients with this connective tissue disorder...
September 2016: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/26896944/pulsed-radiofrequency-on-radial-nerve-under-ultrasound-guidance-for-treatment-of-intractable-lateral-epicondylitis
#20
Dae Seok Oh, Tae Hyung Kang, Hyae Jin Kim
Lateral epicondylitis is a painful and functionally limiting disorder. Although lateral elbow pain is generally self-limiting, in a minority of people symptoms persist for a long time. When various conservative treatments fail, surgical approach is recommended. Surgical denervation of several nerves that innervate the lateral humeral epicondyle could be considered in patients with refractory pain because it denervates the region of pain. Pulsed radiofrequency is a minimally invasive procedure that improves chronic pain when applied to various neural tissues without causing any significant destruction and painful complication...
June 2016: Journal of Anesthesia
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