NEUROMODULATION

H-Coil Repetitive Transcranial Magnetic Stimulation Relieves Pain and Symptoms of Anxiety and Depression in Patients With Chronic Peripheral Neuropathic Pain: A Randomized Sham-Controlled Crossover Study
Farnes N, Stubhaug A, Hansson P and Vambheim SM
This study aimed to investigate the analgesic effects of H-coil repetitive transcranial magnetic stimulation (rTMS) primarily targeting the hand area of the primary motor cortex (M1) in patients with peripheral neuropathic pain. Given that the H-coil has a wider reach than conventional coils, there is a possibility that targeting the hand motor cortex also may stimulate prefrontal areas. Thus, we also aimed to examine whether rTMS with an M1 target could produce effects on psychologic outcomes.
Field H1 of Forel vs Subthalamic Nucleus Electrical Stimulation in Parkinson's Disease: Long-term Effects on Motor Symptoms and Quality of Life
Rodrigues JPA, Rocha MSG, Laube KAC, Iglesio R, Filho PRT, Freitas JL, Figueiredo EG, Carlotti CG, Soriano DC and Godinho F
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) relieves motor symptoms, including levodopa-responsive gait disorders in Parkinson's disease (PD). Traditionally, STN-DBS is not indicated to treat severe, clinically resistant axial symptoms. In this scenario, field H1 of Forel (FF) stimulation (FF-DBS) is likely a feasible option, given it improves motor symptoms, including freezing of gait (FOG), as shown by a short-term study. However, no data are available about the long-term effects of this therapy. Finally, no study has compared the long-term effects of FF and STN-DBS.
Ultra-High Frequency Spinal Nerve Neuromodulation for Improving Bladder Continence: Implications for Overactive Bladder Management
Lin BS, Khasanah N, Cai CY, Wu CW, Lu KH, Lin WT and Peng CW
Ultrahigh frequencies (UHF) have been shown to selectively suppress the sensory pathway with a rapid onset and prolonged effect compared with low frequencies. Few studies have explored the feasibility of UHF electrical stimulation in treating overactive bladder. This study aimed to investigate whether bladder overactivity could be inhibited by UHF stimulation at the L6 nerve root.
The Retrograde Approach of Surgical Paddle-Lead Placement for Spinal Cord Stimulation
Awad AJ, Murray MM, Morris JL and Pahapill PA
Standard anterograde placement of a surgical paddle lead (SPL) for spinal cord stimulation (SCS) can be challenging in patients with scarring from prior spine surgery, instrumentation obstructing the targeted level, or severe stenosis below the targeted level. One potential alternative is retrograde (caudal) insertion by performing laminotomies cephalad to the targeted levels. The literature is limited to only a small number of individual cases describing this technique. In this report, the authors present their experience over the last ten years of the retrograde insertion of SPLs for SCS.
Modulation of Local Field Potentials in the Deep Brain of Minipigs Through Transcranial Temporal Interference Stimulation
Lin HC, Wu YH and Ker MD
Transcranial temporal interference stimulation (tTIS) is a novel, noninvasive neuromodulation technique to modulate deep brain neural activity. Despite its potential, direct electrophysiological evidence of tTIS effects remains limited. This study investigates the impact of tTIS on local field potentials (LFPs) in the deep brain using minipigs implanted with deep brain electrodes.
YouTube as a Source of Medical Information About Peripheral Nerve Stimulation
Gupta A, Beletsky A, Shen AY, Chin W, Liu C and Reddy R
YouTube is an important source of medical information for various medical topics and procedures. The purpose of the present study is to appraise the quality of medical information available on YouTube on the topic of peripheral nerve stimulation (PNS) for chronic pain.
Seeking Optimal Montage for Single-Pair Transcranial Direct Current Stimulation Using Bayesian Optimization and Hyperband-A Feasibility Study
Im C, Lee J, Kim D, Jun SC and Seo H
Transcranial direct current stimulation (tDCS) is an emerging neuromodulation technique. The effect of tDCS can vary significantly depending on electrode position and current intensity, making it crucial to find an optimized tDCS montage. However, because of the high computational load, most tDCS optimization approaches have been performed with a limited number of candidates for electrode positions, such as 10-10 or 10-20 international channel configurations. This study introduced the Bayesian optimization and hyperband (BOHB) method to seek optimal tDCS montage for the entire human scalp without conventional constraints.
Efficacy and Safety of Noninvasive Electrical Neuromodulation for Treatment of Functional Constipation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Long S, Ji S, Nojkov B and Chen JDZ
Functional constipation (FC) is a prevalent disorder with large disease burden and high associated cost. Noninvasive electrical neuromodulation (NEN) has been studied for treatment of FC, but its overall efficacy and safety remain unclear. This meta-analysis evaluates the efficacy and safety of NEN for treatment of FC.
Neuromodulation and Disorders of Consciousness: Systematic Review and Pathophysiology
Dutta RR, Abdolmanafi S, Rabizadeh A, Baghbaninogourani R, Mansooridara S, Lopez A, Akbari Y and Paff M
Disorders of consciousness (DoC) represent a range of clinical states, affect hundreds of thousands of people in the United States, and have relatively poor outcomes. With few effective pharmacotherapies, neuromodulation has been investigated as an alternative for treating DoC. To summarize the available evidence, a systematic review of studies using various forms of neuromodulation to treat DoC was conducted.
Personalized Theta Transcranial Alternating Current Stimulation and Gamma Transcranial Alternating Current Stimulation Bring Differential Neuromodulatory Effects on the Resting Electroencephalogram: Characterizing the Temporal, Spatial, and Spectral Dimensions of Transcranial Alternating Current Stimulation
Venugopal R, Sasidharan A, Bhowmick K, Nagaraj N, Udupa K, John JP and Kutty BM
The neuromodulatory effects of transcranial alternating current stimulation (tACS) on electroencephalogram (EEG) dynamics are quite heterogenous. The primary objective of the study is to comprehensively characterize the effects of two tACS protocols on resting-state EEG.
The Effect of Spinal Cord Stimulation on Spinal Dorsal Horn Lipid Expression in Experimental Painful Diabetic Polyneuropathy: A Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry Imaging Study
de Geus TJ, Franken G, Flinders B, Cuypers E and Joosten EAJ
Diabetes-induced peripheral nerve fiber damage can cause painful diabetic polyneuropathy (PDPN), induced by central sensitization through proinflammatory processes in the spinal dorsal horn. Disturbances in spinal dorsal horn lipid metabolism play a major role in proinflammatory regulation. Conventional (Con)-spinal cord stimulation (SCS) is an alternative treatment for pain relief in PDPN, whereas differential target multiplexed (DTM)-SCS could be more effective than Con-SCS, specifically targeting the spinal inflammatory response. We hypothesize that Con- and DTM-SCS differentially affect lipid metabolism in the spinal cord of PDPN animals. To study pain relief mechanisms, we analyzed lipid expression in the spinal dorsal horn using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry imaging (MSI).
Twelve-Month Clinical Trial Results of a Novel, Dorsal Horn Dendrite Stimulation Waveform for Chronic Neuropathic Low Back Pain
Russo MA, Volschenk W, Bailey D, Santarelli DM, Holliday E, Barker D, Dizon J and Graham B
The aim of this study was to evaluate the effectiveness and safety of a novel subperception spinal cord stimulation (SCS) waveform paradigm designed to target the dorsal horn dendrites for treating chronic neuropathic low back pain (LBP). The final 12-month results are reported here.
Effect of Neurostimulation on Chronic Pancreatic Pain: A Systematic Review
Andrade MF, Fabris-Moraes W, Pacheco-Barrios K and Fregni F
Chronic pancreatic pain is one of the most severe causes of visceral pain, and treatment response is often limited. Neurostimulation techniques have been investigated for chronic pain syndromes once there are pathophysiological reasons to believe that these methods activate descending pain inhibitory systems. Considering this, we designed this systematic literature review to investigate the evidence on neuromodulation techniques as a treatment for chronic pancreatic pain.
Peripheral Nerve Stimulation for Pain Management: A Survey of Clinical Practice Patterns
Karri J, Sivanesan E, Gulati A, Singh V, Sheen S, Yalamuru B, Wang EJ, Javed S, Chung M, Sohini R, Hussain N and D'Souza RS
Clinical interest in and utilization of peripheral nerve stimulation (PNS) for treating chronic pain has significantly increased in recent years owing to its potential for providing analgesia and improved function and quality of life in comparison with pharmacologic treatments. However, the relative infancy of PNS-specific systems and limited clinical practice guidance likely contribute to significant variation in PNS utilization patterns.
Motor Response Matters: Lead Placement and Urologic Efficacy Linked in Sacral Neuromodulation
Tilborghs S, Brits T, van de Borne S, Vaganée D and de Wachter S
This study aimed to characterize the pelvic floor muscles (PFM) motor response provoked during sacral neuromodulation (SNM) lead placement, determining its utility in improving therapy delivery.
Cervical Spinal Cord Stimulation for Treatment of Sympathetically Mediated Orofacial Pain: Case Series and Narrative Review
Malik A, D'Souza RS, Karri J and Javed S
Sympathetically mediated orofacial pain is a rare form of craniofacial pain that may be refractory to conventional medical management. We report two cases of orofacial pain with sympathetic features treated with cervical spinal cord stimulation (SCS) using burst waveform with passive recharge. In addition, we present a narrative review of cervical SCS use in the management of orofacial pain.
A Proposed Psychologic Clearance Algorithm for Spinal Cord Stimulation Implantation Supported by a Scoping Review
Fisher K, Furtado-Pessoa-de-Mendonca L, Kaushal S, Sterling L, Hallo Carrasco A, Pagan Rosado R, Hallo C, Cael Aoki K, Caceres J, Prokop L, Rodriguez SE and Hunt CL
Patients with refractory chronic pain may be considered for spinal cord stimulation (SCS) as an interventional therapy. Studies have shown that psychiatric disorders are associated with worse outcomes. However, this relationship may not be understood by all healthcare professionals. Despite psychologic clearance and proper indication, pain medicine physicians often find themselves questioning the appropriateness of some candidates. The authors conducted a scoping review to identify assessments ascertaining patients with pronounced psychiatric burden that may complicate optimal response, to identify any clearly defined psychiatric contraindications, and to review ways psychiatric comorbidities may be addressed in patients at risk for suboptimal long-term response.
Perceptual and Cognitive Effects of Focal Transcranial Direct Current Stimulation of Auditory Cortex in Tinnitus
Leaver AM
Transcranial direct current stimulation (tDCS) has been studied as a potential treatment for many brain conditions. Although tDCS is well tolerated, continued study of perceptual and cognitive side effects is warranted, given the complexity of functional brain organization. This study tests the feasibility of brief tablet-based tasks to assess auditory and cognitive side effects in a recently reported pilot study of auditory-cortex tDCS in chronic tinnitus and attempts to confirm that this untested multisession tDCS protocol does not worsen hearing.
A Prospective Single-center Pilot Study on the Use of Closed-loop Spinal Cord Stimulation to Treat Chronic Pain Associated With Raynaud's Phenomenon
Maciaczyk J, Bara G, Basilaia B, Abuassi M, Dietz BE, Mugan D, Mayr A, Staerk C, Karakostas P and Schäfer VS
Raynaud's phenomenon (RP) is a vascular disorder characterized by episodic peripheral artery vasospasms, resulting in paleness, cyanosis, and/or erythema. There are few reports, mostly case reports, on the benefits of spinal cord stimulation (SCS) for the treatment of RP. However, there is a lack of objective evidence on SCS-induced modulation of the sympathetic system (eg, vasodilation) in this condition. We hypothesize that evoked compound action potential-controlled closed-loop SCS may relieve pain, reduce the severity and frequency of Raynaud attacks, and improve peripheral blood flow.
Weight Trends After Spinal Cord Stimulation Therapy for Chronic Pain
Kremer C, Berger A, Bernstein K, Korach T and Mogilner A
Spinal cord stimulation (SCS) therapy is an effective treatment for chronic pain, particularly in conditions such as postlaminectomy syndrome and complex regional pain syndrome (CRPS). Rare case reports described significant weight loss in patients who underwent dorsal column SCS therapy for chronic pain. Recently, neuromodulation for obesity has become a novel field for research. We aimed to investigate weight trends among patients treated with SCS for chronic pain.
Impact of Preoperative Cognition on Motor Improvement in Bilateral Subthalamic Nucleus-Deep Brain Stimulation for Parkinson's Disease
Sisodia V, Ursinus R, Geurtsen GJ, Wiggerts Y, Schuurman PR, Beudel M, de Bie RMA and Swinnen BEKS
This study aimed to assess the influence of preoperative cognition on postoperative motor and nonmotor outcomes in patients with Parkinson disease (PD) after deep brain stimulation (DBS).