Less Pain Relief, More Depression, and Female Sex Correlate With Spinal Cord Stimulation Explants
BackgroundSpinal cord stimulation (SCS) is a known therapy for a variety of chronic pain conditions, but over time a number of patients proceed to explants.ObjectivesWe compared explant rates based on degree of pain relief, diagnosis, lead location, gender, and age to determine possible predictors for SCS implant success.MethodsFirst, we performed a single ‐center retrospective chart review of consecutive SCS‐implanted subjects was to document internal explant rates. Rates of explants based on diagnosis, gender, age, and lead location were compared to determine potential trends. We then examined which thoracic SCS pati...
Source: Neuromodulation: Technology at the Neural Interface - August 19, 2019 Category: Biotechnology Authors: Julia Slyer, Samae Scott, Breanna Sheldon, Maria Hancu, Cheyanne Bridger, Julie G. Pilitsis Tags: Clinical Research Source Type: research

Cost ‐Effectiveness Analysis of Peripheral Nerve Field Stimulation as Add‐On Therapy to Spinal Cord Stimulation in the Treatment of Chronic Low Back Pain in Failed Back Surgery Syndrome Patients
ConclusionsFrom a Dutch national health ‐care context, when the willingness to pay threshold is up to 60.000 Euros per QALY, PNFS as an add‐on therapy to SCS for the treatment of low back pain in FBSS patients has a high probability of being cost‐effective. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - August 18, 2019 Category: Biotechnology Authors: Eric ‐Jan J.A.A van Gorp, Eddy M.M. Adang, Ismail Gültuna, Tanja E. Hamm‐Faber, Katja Bürger, Jan Willem Kallewaard, Johannes W.C.L Schapendonk, Leon Vonhögen, Ewald Bronkhorst, Onno P. Teernstra, Kris C.P. Vissers Tags: Clinical Research Source Type: research

Comparing Current Steering Technologies for Directional Deep Brain Stimulation Using a Computational Model That Incorporates Heterogeneous Tissue Properties
ConclusionWhile current fractionalization technologies can achieve current steering between two segmented electrodes, this study shows that there are important limitations in accuracy and focus of tissue activation when tissue heterogeneity is accounted for. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - August 18, 2019 Category: Biotechnology Authors: Simeng Zhang, Peter Silburn, Nader Pouratian, Binith Cheeran, Lalit Venkatesan, Alexander Kent, Alfons Schnitzler Tags: Basic Research Source Type: research

Efficiency and Safety of Aftercare With Intrathecal Baclofen on Location
ConclusionsThe concept of ITB aftercare on location demonstrated efficacy and safety in the described setting. For troubleshooting, close collaboration with a neuromodulation center is necessary and can be arranged in chain ‐based care. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - August 18, 2019 Category: Biotechnology Authors: Simone M.E. Goslinga ‐van der Gaag, Elmar M. Delhaas, Sander P.G. Frankema, Frank J.P.M. Huygen Tags: Clinical Research Source Type: research

Electrical Colon Stimulation Reflexively Increases Colonic Activity
ConclusionsDistal colon stimulation evoked colonic activity. The dependence of this response on stimulation location and anesthesia suggests that responses were reflex mediated. Colonic stimulation may have the potential to improve colonic motility for individuals with neurogenic bowel dysfunction. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - August 16, 2019 Category: Biotechnology Authors: Dennis Bourbeau, Kelsey Aamoth, Steven Brose, Kenneth Gustafson Tags: Basic Research Source Type: research

Therapeutic High ‐Frequency Repetitive Transcranial Magnetic Stimulation Concurrently Improves Mood and Anxiety in Patients Using Benzodiazepines
In this study, we tested the use of repetitive transcranial magnetic stimulation (rTMS) to reduce depression and anxiety in patients using or not using benzodiazepines. We hypothesized that rTMS would concurrently reduce symptoms in both depression and anxiety and that these reductions would correlate with patients using benzodiazepines.Materials and MethodsThis retrospective study screened for patients treated in a TMS clinic within a five ‐year period. Each patient had received high‐frequency (10 or 20 Hz) rTMS over the left dorsolateral prefrontal cortex and completed pre‐ and posttreatment Beck Depression Invento...
Source: Neuromodulation: Technology at the Neural Interface - August 1, 2019 Category: Biotechnology Authors: Kevin A. Caulfield, Adam P. Stern Tags: Clinical Research Source Type: research

Clarifying the Scientific Knowledge Pertaining to Burst Waveforms in Spinal Cord Stimulation
Neuromodulation: Technology at the Neural Interface, EarlyView. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 30, 2019 Category: Biotechnology Authors: Jianwen Wendy Gu, Elbert A.J. Joosten Tags: Letter to the Editor Source Type: research

Trial SCS Leads Should Be Removed under Fluoroscopy
Neuromodulation: Technology at the Neural Interface, EarlyView. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 30, 2019 Category: Biotechnology Authors: John V. Prunskis, Terri Dallas ‐Prunskis Tags: Letter to the Editor Source Type: research

Design and Evaluation of a Rodent ‐Specific Transcranial Magnetic Stimulation Coil: An In Silico and In Vivo Validation Study
ConclusionComputer simulations motivated the design of a smaller rodent ‐specific TMS coil, but came short in explaining the capability of a larger commercial human coil to induce unilateral MEPsin vivo. Lateralized TMS, as demonstrated for both TMS coils, corroborates their use in translational rodent studies, to elucidate mechanisms of action of therapeutic TMS protocols. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 29, 2019 Category: Biotechnology Authors: Julia Boonzaier, Petar I. Petrov, Willem M. Otte, Nickolay Smirnov, Sebastiaan F.W. Neggers, Rick M. Dijkhuizen Tags: Basic Research Source Type: research

Transcranial Static Magnetic Field Stimulation Over the Temporal Cortex Modulating the Right Ear Advantage in Dichotic Listening
ConclusionsThe preliminary results of the present exploratory study demonstrate the ability of tSMS to modulate human brain activity on a behavioral as well as physiologic level. Furthermore, tSMS effects on acoustic processing may have clinical implications by fostering potential approaches for a treatment of speech ‐related pathologies associated with hyperexcitability in the AC. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 29, 2019 Category: Biotechnology Authors: Kai Heimrath, Alexander Spr öggel, Stefan Repplinger, Hans‐Jochen Heinze, Tino Zaehle Tags: Basic Research Source Type: research

Pocket Fill During Intrathecal Pump Refill: Is it a Frequent Occurrence?
Neuromodulation: Technology at the Neural Interface, EarlyView. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 29, 2019 Category: Biotechnology Authors: Alaa Abd ‐Elsayed Tags: Letter to the Editor Source Type: research

Periprocedural Considerations for Patients with Gastric Electrical Stimulators
ConclusionsAvailable data suggests GES is a technology with increasing prevalence. When patients with an implanted GES device present for periprocedural care, the anesthesia staff must consider the device when planning for the procedure. Topics addressed include general anesthetic considerations, nerve localization, radiation exposure, electrocautery, diathermy, emergency external defibrillation, and MRI compatibility. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 29, 2019 Category: Biotechnology Authors: Weston Case Nadherny, Brooke Anderson, Alaa Abd ‐Elsayed Tags: Review Article Source Type: research

Ameliorating Effects of Transcutaneous Electrical Acustimulation Combined With Deep Breathing Training on Refractory Gastroesophageal Reflux Disease Mediated via the Autonomic Pathway
AimsTo investigate the effects and possible mechanisms of transcutaneous electrical acustimulation (TEA) combined with deep breathing training (DBT) on refractory gastroesophageal reflux disease (rGERD).MethodsTwenty ‐one patients with rGERD were recruited and randomly assigned to receive either only esomeprazole (ESO, 20 mg bid) (group A, n = 7), TEA + DBT + ESO (group B, n = 7), or sham‐TEA + DBT + ESO (group C, n = 7) in a four‐week study. The reflux diagnostic questionnaire (RDQ) score and heart rate variability (HRV) were recorded and evaluated at baseline and at the end of each treatment. Blood samples w...
Source: Neuromodulation: Technology at the Neural Interface - July 26, 2019 Category: Biotechnology Authors: Yue Yu, Ruiling Wei, Zhi Liu, Jiaqin Xu, Chao Xu, Jiande D. Z. Chen Tags: Clinical Research Source Type: research

Anatomic Lead Placement Without Paresthesia Mapping Provides Effective and Predictable Therapy During the Trial Evaluation Period: Results From the Prospective, Multicenter, Randomized, DELIVERY Study
ObjectiveThe purpose of this study was to compare the trial success rate between anatomic lead placement (AP) and paresthesia ‐mapped (PM) lead placement techniques for spinal cord stimulation (SCS) using a nonlinear burst stimulation pattern.Materials and MethodsEligible patients with back and/or leg pain with a Numeric Rating Scale (NRS) score of ≥6 who had not undergone previous SCS were enrolled in the study. A total of 270 patients were randomized in a 1:1 ratio to each treatment arm. In the AP group, one lead tip was placed at the mid‐body of T8, and the other at the superior endplate of T9. In the PM group, p...
Source: Neuromodulation: Technology at the Neural Interface - July 19, 2019 Category: Biotechnology Authors: Jason E. Pope, Stefan Schu, Dawood Sayed, Ahmed M. Raslan, Ganesan Baranidharan, Robert D. Heros, Bram Blomme, Robyn A. Capobianco, Timothy R. Deer Tags: Clinical Research Source Type: research

Clinical Efficacy of Bilateral Deep Brain Stimulation Does Not Change After Implantable Pulse Generator Replacement but the Impedances Do: A Prospective Study
ConclusionAlthough there were no statistically significant changes in the motor functions of all patients after elective IPG replacement, the therapy impedances were significantly higher and TEED was significantly lower after IPG replacement with concurrent Pocket Adapter implantation. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 19, 2019 Category: Biotechnology Authors: Marcel Niemann, Gerd ‐Helge Schneider, Andrea Kühn, Peter Vajkoczy, Katharina Faust Tags: Clinical Research Source Type: research

Is Sacral Nerve Modulation a Good Option for Fecal Incontinence in Men?
ConclusionBoth short ‐ and long‐term success rates of SNM for FI were lower in men than in women. The revision and definitive explantation for long‐term infection rates were significantly higher in men. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 18, 2019 Category: Biotechnology Authors: Charl ène Brochard, Diane Mege, Valérie Bridoux, Guillaume Meurette, Henri Damon, Elsa Lambrescak, Jean‐Luc Faucheron, Bertrand Trilling, Paul‐Antoine Lehur, Vincent Wyart, Igor Sielezneff, François Mion, Isabelle Etienney, Anne‐Mari Tags: Clinical Research Source Type: research

Calendar of Events
Neuromodulation: Technology at the Neural Interface, Volume 22, Issue 5, Page 667-668, July 2019. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 17, 2019 Category: Biotechnology Tags: Professional Development Source Type: research

Table of Contents
Neuromodulation: Technology at the Neural Interface, Volume 22, Issue 5, Page iii-vi, July 2019. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 17, 2019 Category: Biotechnology Tags: Issue Information – Table of Contents Source Type: research

Editorial Board
Neuromodulation: Technology at the Neural Interface, Volume 22, Issue 5, Page i-i, July 2019. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 17, 2019 Category: Biotechnology Tags: Issue Information – Editorial Board Source Type: research

Aims and Scope
Neuromodulation: Technology at the Neural Interface, Volume 22, Issue 5, Page ii-ii, July 2019. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 17, 2019 Category: Biotechnology Tags: Issue Information – Aims and Scope Source Type: research

Effectiveness of Neurostimulation Technologies for the Management of Chronic Pain: A Systematic Review
ConclusionsA robust body of evidence examining SCS and PNS was identified. Only one study for PNFS and TENS was identified; both reported pain reductions. Generally, neurostimulation improved pain control. Future studies should examine the effectiveness of neurostimulation offered early in the trajectory of chronic pain. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 16, 2019 Category: Biotechnology Authors: Mark Hofmeister, Ally Memedovich, Sage Brown, Manik Saini, Laura E. Dowsett, Diane L. Lorenzetti, Tamara L. McCarron, Gail MacKean, Fiona Clement Tags: Review Article Source Type: research

Randomized Placebo ‐/Sham‐Controlled Trials of Spinal Cord Stimulation: A Systematic Review and Methodological Appraisal
ConclusionsTo date the methods of placebo/sham control and blinding in RCTs have been poorly reported, leading to concerns about the validity and replicability of the findings. Important aspects that need to be clearly reported in the design of placebo ‐/sham‐controlled RCTs of SCS include the transparent reporting of stimulation programming parameters, patient position during perception threshold measurement, management of the patient handheld programmer, frequency of recharging, and assessment of the fidelity of blinding. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 15, 2019 Category: Biotechnology Authors: Rui V. Duarte, Ewan McNicol, Luana Colloca, Rod S. Taylor, Richard B. North, Sam Eldabe Tags: Review Article Source Type: research

Outcomes of a Multicenter, Prospective, Crossover, Randomized Controlled Trial Evaluating Subperception Spinal Cord Stimulation at ≤1.2 kHz in Previously Implanted Subjects
DiscussionSubperception SCS at ≤1.2 kHz is safe and effective in subjects with extreme physical disability and previously implanted for chronic pain. Further, by providing study participants with different waveform options, increased pain relief was achieved. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - July 2, 2019 Category: Biotechnology Authors: James North, Eric Loudermilk, Albert Lee, Harsh Sachdeva, Demetrios Kaiafas, Edward Washabaugh, Samir Sheth, James Scowcroft, Nagy Mekhail, Benjamin Lampert, Thomas Yearwood, Erik Shaw, Joseph Atallah, Carroll McLeod, John Han, Cong Yu, Ma Tags: Clinical Research Source Type: research

Electrical Stimulation of Back Muscles Does Not Prime the Corticospinal Pathway
ConclusionResults indicate that, unlike previous reports that show increased corticospinal excitability of limb muscles, PES of back muscles does not modify the corticospinal excitability. This difference in response of the motor pathway of back muscles to PES might be explained by the lesser importance of voluntary cortical drive to these muscles and the greater role of postural networks. Whether PES influences back muscle training remains unclear, yet the present results suggest that potential effects are unlikely to be explained by the effects of PES at corticospinal level with the parameters used in this study. (Source...
Source: Neuromodulation: Technology at the Neural Interface - June 24, 2019 Category: Biotechnology Authors: Edith Elgueta ‐Cancino, Hugo Massé‐Alarie, Siobhan M. Schabrun, Paul W. Hodges Tags: Basic Research Source Type: research

Does Spinal Cord Stimulation Due to Failed Back Surgery Syndrome Lead to Permanent Occupational Disability?
ConclusionsUnlike the well ‐analyzed effectiveness of SCS, RTW remains an underutilized outcome measure. The RTW rate in our series was the second lowest in the reviewed literature. We demonstrated that half of the patients with an implanted SCS either did not resume their work or left their job. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - June 24, 2019 Category: Biotechnology Authors: Tomasz Szmuda, Pawe ł Słoniewski, Shan Ali, Katarzyna Aleksandrowicz Tags: Clinical Research Source Type: research

Tissue Temperature Increases by a 10 kHz Spinal Cord Stimulation System: Phantom and Bioheat Model
ConclusionsHeating of spinal tissues by this 10 kHz SCS system theoretically increases quickly with stimulation level and load impedance, while dampened by IPG pulse bandwidth and voltage compliance limitations. If validated in vivo as a mechanism of kHz SCS, bioheat models informed by IPG limitations allow prediction and optimization of temperature changes. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - June 21, 2019 Category: Biotechnology Authors: Adantchede L. Zannou, Niranjan Khadka, Mohamad FallahRad, Dennis Q. Truong, Brian H. Kopell, Marom Bikson Tags: Basic Research Source Type: research

Evoked Potentials Recorded From the Spinal Cord During Neurostimulation for Pain: A Computational Modeling Study
ConclusionOur modeling results suggest that clinically effective SCS relies on the activation of numerous axons within a narrow fiber diameter range and that several factors affect the composition of the ECAP recordings. These results can improve how we interpret and implement these recordings in a potential closed ‐loop approach to SCS. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - June 19, 2019 Category: Biotechnology Authors: Carlos J. Anaya, Hans J. Zander, Robert D. Graham, Vishwanath Sankarasubramanian, Scott F. Lempka Tags: Basic Research Source Type: research

Implantable Pulse Generator Site May Be Associated With Spinal Cord Stimulation Revision Surgeries
ConclusionAlthough this study found a significant association between IPG site and revision surgeries, the effect of IPG site was not found to be predictive. The IPG site likely influences whether a patient will require revision surgery, but further investigation is required to establish this association. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - June 19, 2019 Category: Biotechnology Authors: Shyle H. Mehta, Christian M. Hoelscher, Ashwini D. Sharan, Sara Thalheimer, Chengyuan Wu Tags: Clinical Research Source Type: research

Evoked Compound Action Potentials Reveal Spinal Cord Dorsal Column Neuroanatomy
DiscussionECAP dispersion increases with propagation distance due to the contribution of slow ‐conducting small‐diameter fibers as the signal propagates away from the source. An analysis of the discontinuities in ECAP dispersion changes with propagation revealed that these are due to the termination of smaller‐diameter, slower‐conducting fibers at corresponding segmental levels. The implications regarding SCS lead placement, toward the goal of maximizing clinical benefit while minimizing side‐effects, are discussed.Conflict of InterestJohn Parker is the founder and CEO of Saluda Medical and holds stock options. M...
Source: Neuromodulation: Technology at the Neural Interface - June 19, 2019 Category: Biotechnology Authors: John L. Parker, Milan Obradovic, Nastaran Hesam Shariati, Robert B. Gorman, Dean M. Karantonis, Peter S. Single, James Laird ‐Wah, Mark Bickerstaff, Michael J. Cousins Tags: Basic Research Source Type: research

Outcomes of Sacral Nerve Stimulation for Treatment of Refractory Overactive Bladder Among Octogenarians
ConclusionsThe safety and efficacy of SNS was similar between cohorts. This result suggests that SNS is a safe and effective therapy that should be considered among the treatment options for refractory OAB in octogenarian patients. Further studies are needed to determine predictive factors of Stage I success in elderly patients. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - June 19, 2019 Category: Biotechnology Authors: Daniel R. Greenberg, Raveen Syan, Nichole Young ‐Lin, Craig V. Comiter, Ekene Enemchukwu Tags: Clinical Research Source Type: research

Calendar of Events
Neuromodulation: Technology at the Neural Interface, Volume 22, Issue 4, Page 507-508, June 2019. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - June 17, 2019 Category: Biotechnology Tags: Professional Development Source Type: research

Table of Contents
Neuromodulation: Technology at the Neural Interface, Volume 22, Issue 4, Page iii-vi, June 2019. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - June 17, 2019 Category: Biotechnology Tags: Issue Information – Table of Contents Source Type: research

Editorial Board
Neuromodulation: Technology at the Neural Interface, Volume 22, Issue 4, Page i-i, June 2019. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - June 17, 2019 Category: Biotechnology Tags: Issue Information – Editorial Board Source Type: research

Aims and Scope
Neuromodulation: Technology at the Neural Interface, Volume 22, Issue 4, Page ii-ii, June 2019. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - June 17, 2019 Category: Biotechnology Tags: Issue Information – Aims and Scope Source Type: research

Observations of Autonomic Variability Following Central Neuromodulation for Chronic Neuropathic Pain in Spinal Cord Injury
In this study, we explored the proposed PNM‐CAN mechanism in SCI + NP and AB cohorts following centrally‐directed neuromodulation to assess if the PNM and CAN are capable of being differentially modulated.Materials and MethodsCentral neuromodulation was administered via breathing ‐controlled electrical stimulation (BreEStim), previously evidenced to operate at the PNM. To quantify CAN activity, conventional heart rate variability (HRV) recordings were used to gather time and frequency domain parameters of autonomic modulation. SCI + NP (n = 10) and AB (n = 13) cohorts received null and act...
Source: Neuromodulation: Technology at the Neural Interface - June 14, 2019 Category: Biotechnology Authors: Jay Karri, Shengai Li, Yen ‐Ting Chen, Argyrios Stampas, Sheng Li Tags: Clinical Research Source Type: research

Burst Occipital Nerve Stimulation for Chronic Migraine and Chronic Cluster Headache
ConclusionParaesthesia is not necessary for good quality analgesia in ONS. Larger studies will be required to determine whether the efficacies of the two stimulation modes differ. Burst ONS is imperceptible and therefore potentially amenable to robustly blinded clinical trials. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - June 14, 2019 Category: Biotechnology Authors: Rodrigo Garcia ‐Ortega, Tamara Edwards, Liz Moir, Tipu Z. Aziz, Alexander L. Green, James J. FitzGerald Tags: Case Series Source Type: research

Cortical Mapping in Conventional and High Dose Spinal Cord Stimulation: An Exploratory Power Spectrum and Functional Connectivity Analysis With Electroencephalography
ObjectivesSpinal cord stimulation (SCS) is considered an effective pain ‐relieving treatment for patients with Failed Back Surgery Syndrome (FBSS). Despite the clinical effectiveness, it is unknown whether the altered functional connectivity in such patients, as compared to healthy persons, can be influenced by SCS. Therefore, the goal of this study is to evaluate whe ther brain connectivity assessed by EEG differs between baseline and SCS in patients with FBSS.Materials and MethodsEight patients with FBSS underwent a resting ‐state EEG protocol before SCS, 1.5 months and 2.5 months after receiving SCS. At each frequen...
Source: Neuromodulation: Technology at the Neural Interface - June 10, 2019 Category: Biotechnology Authors: Lisa Goudman, Bengt Linderoth, Guy Nagels, Eva Huysmans, Maarten Moens Tags: Basic Research Source Type: research

Modulation of Spinal Nociceptive Transmission by Sub ‐Sensory Threshold Spinal Cord Stimulation in Rats After Nerve Injury
ConclusionsTraditional suprathreshold SCS acutely inhibits spinal nociceptive transmission. Low ‐frequency subthreshold SCS with a long pulse width (200 Hz, 1 msec), but not higher‐frequency SCS, also attenuates C‐LFP. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - June 4, 2019 Category: Biotechnology Authors: Fei Yang, Wanru Duan, Qian Huang, Zhiyong Chen, Neil Ford, Xinyan Gao, Eellan Sivanesan, Sridevi V. Sarma, Louis P. Vera ‐Portocarrero, Bengt Linderoth, Srinivasa N. Raja, Yun Guan Tags: Basic Research Source Type: research

Redefining Spinal Cord Stimulation “Trials”: A Randomized Controlled Trial Using Single‐Stage Wireless Permanent Implantable Devices
ConclusionUsing wireless SCS devices that allow for an extended trial period and evaluation of various waveforms, we observed a high rate trial success rate with both HFS and LFS waveforms, with minimal incidence of infection. Long ‐term follow‐up will address the cost‐effectiveness and morbidity associated with this technology, which facilitates single‐stage treatment. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - June 3, 2019 Category: Biotechnology Authors: Richard B. North, Aaron Calodney, Robert Bolash, Konstantin V. Slavin, Michael Creamer, Richard Rauck, Payam Vahedifar, Ira Fox, Cuneyt Özaktay, Sunil Panchal, Niek Vanquathem Tags: Clinical Research Source Type: research

Intrathecal Baclofen Therapy in Patients With Multiple Sclerosis: Improved Outcomes and Reduced Costs Through Identification of Catheter Malfunction
DiscussionThese cases illustrate the need for early ITB pump troubleshooting to identify catheter problems, improve efficacy, and avoid unnecessary healthcare costs. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - June 3, 2019 Category: Biotechnology Authors: Mary Elizabeth S. Nelson, John R. McGuire Tags: Case Series Source Type: research

Elevation of Lower Esophageal Sphincter Pressure With Acute Transcutaneous Electrical Acustimulation Synchronized With Inspiration
BackgroundGastroesophageal reflux disease (GERD) is a common esophageal disorder. Transcutaneous electrical acustimulation (TEA), as a needleless method of electroacupuncture (EA) has been reported to improve hypotensive lower esophageal sphincters pressure (LESP) in GERD. Synchronized TEA (STEA) with inspiration has been revealed to be more effective than TEA in enhancing vagal tone.AimTo explore the effect of STEA on LESP in GERD and possible mechanisms involving autonomic functions.MethodsSixty patients were randomly allocated into a STEA group (45 patients) and sham ‐TEA group (15 patients). The ECG was recorded for ...
Source: Neuromodulation: Technology at the Neural Interface - May 28, 2019 Category: Biotechnology Authors: Zhaoxiu Liu, Dewen Lu, Jie Guo, Yanmei Liu, Zhaohong Shi, Feng Xu, Lin Lin, Jiande D.Z. Chen Tags: Clinical Research Source Type: research

Response to “Safety Analysis of Dorsal Root Ganglion Stimulation in the Treatment of Chronic Pain”
Neuromodulation: Technology at the Neural Interface, EarlyView. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - May 23, 2019 Category: Biotechnology Authors: Eellan Sivanesan, Steven P. Cohen Tags: Letter to the Editor Source Type: research

The Effects of Anodal Transcranial Direct Current Stimulation on the Walking Performance of Chronic Hemiplegic Patients
DiscussionThese results showed a significant positive effect of a single session of anodal tDCS of the M1 ‐LL in chronic hemiplegic patients. This proof‐of‐concept study supports the conduct of clinical studies evaluating the effectiveness of a walking training program associated with iterative tDCS stimulation.Conflict of InterestThe authors reported no conflict of interest. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - May 23, 2019 Category: Biotechnology Authors: Etienne Ojardias, Oscar Dagb émabou Azé, Davy Luneau, Janis Mednieks, Agnès Condemine, Diana Rimaud, Fanette Chassagne, Pascal Giraux Tags: Clinical Research Source Type: research

Characterization of Effect of Repeated Bolus or Continuous Intrathecal Infusion of Morphine on Spinal Mass Formation in the Dog
BackgroundWe determined whether intrathecally delivering the same daily dose of morphine (MS) at a fixed concentration of 25  mg/mL by periodic boluses versus continuous infusion would reduce intrathecal mass (IMs) formation in dogs.MethodsAdult dogs (hound cross,n = 32) were implanted with intrathecal catheters connected to SynchroMed II infusion pumps. Animals were randomly assigned to receive infusion of 0.48 mL/day of saline or MS dosing (12 mg/day at 25 mg/mL) as boluses: x1 (q24hour), x2 (q12hour), x4 (q6hour), or x8 (q3hour) given at the rate of 1000 μL/hour, or as...
Source: Neuromodulation: Technology at the Neural Interface - May 23, 2019 Category: Biotechnology Authors: Keith R. Hildebrand, Linda M. Page, Tina M. Billstrom, Joanne J. Steinauer, Kelly A. Eddinger, Shervin Arjomand, Tony L. Yaksh Tags: Basic Research Source Type: research

Response to the Letter from Dr. Sivanesan and Dr. Cohen
Neuromodulation: Technology at the Neural Interface, EarlyView. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - May 23, 2019 Category: Biotechnology Authors: Timothy R. Deer, Corey Hunter Tags: Letter to the Editor Source Type: research

Gender Disparities in Deep Brain Stimulation for Parkinson's Disease
This study sought to determine whether there is a gender disparity in patients undergoing deep brain stimulation (DBS) surgery for Parkinson's disease (PD) at a single health system, and better understand the reasons for this discrepancy.Materials and MethodsWe analyzed data from the University of Miami DBS Database, which included 3251 PD patients, using chi ‐square, repeated measures ANOVA, andt tests to examine gender differences in the number of patients referred for surgery, reasons for referral, number receiving/not receiving surgery, reasons for not receiving surgery, and postsurgical outcomes.ResultsDuring the st...
Source: Neuromodulation: Technology at the Neural Interface - May 23, 2019 Category: Biotechnology Authors: Danielle S. Shpiner, Daniel G. Di Luca, Iahn Cajigas, Juan S. Diaz, Jason Margolesky, Henry Moore, Bonnie E. Levin, Carlos Singer, Jonathan Jagid, Corneliu C. Luca Tags: Clinical Research Source Type: research

Low ‐Dose Computed Tomography With Two‐ and Three‐Dimensional Postprocessing as an Alternative to Plain Radiography for Intrathecal Catheter Visualization: A Phantom Pilot Study
ConclusionsWe could correctly identify the catheter and related structures, which supports the investigation of thisin vivo and side ‐by‐side evaluation with plain radiography. If found superior, then this technique may be able to replace plain radiography, while providing better visualization and acceptable radiation exposure.Conflict of InterestDr. Delhaas reports personal fees from Medtronic Inc., as a previous consultant, outside the submitted work; Prof. van der Lugt reports grants from GE Healthcare, Siemens, Stryker, Medtronic, and Penumbra outside the submitted work. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - May 14, 2019 Category: Biotechnology Authors: Elmar M. Delhaas, Aad van der Lugt Tags: Clinical Research Source Type: research

The Importance of the Location of Dorsal Root Ganglion Stimulator Electrodes Within the Nerve Root Exit Foramen
ConclusionAiming for a superodorsal electrode position on lateral intraoperative fluoroscopy is desirable, since siting leads in this location reduces the required stimulator output power very substantially and thus will extend battery life. Position within the foramen does not determine clinical outcome, and so the implanter can safely aim for the low power site without detriment to the analgesic efficacy of the system. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - May 9, 2019 Category: Biotechnology Authors: Sean Martin, George Hadjipavlou, Rodrigo Garcia Ortega, Liz Moir, Tamara Edwards, Stana Bojanic, Alexander L. Green, James J. FitzGerald Tags: Case Series Source Type: research

Effects of Phase Polarity and Charge Balance Spinal Cord Stimulation on Behavior and Gene Expression in a Rat Model of Neuropathic Pain
ObjectiveTo investigate the effect of phase polarity and charge balance of spinal cord stimulation (SCS) waveforms on pain behavior and gene expression in a neuropathic pain rodent model. We hypothesized that differing waveforms will result in diverse behavioral and transcriptomics expression due to unique mechanisms of action.Materials and MethodsRats were implanted with a four ‐contact cylindrical mini‐lead and randomly assigned to two control (no‐pain and pain model) and five test groups featuring monophasic, as well as charge‐unbalanced and charge‐balanced biphasic SCS waveforms. Mechanical and cold allodynia...
Source: Neuromodulation: Technology at the Neural Interface - May 9, 2019 Category: Biotechnology Authors: Ricardo Vallejo, Ashim Gupta, Courtney A. Kelley, Alejandro Vallejo, Jonathan Rink, Joseph M. Williams, Cynthia L. Cass, William J. Smith, Ramsin Benyamin, David L. Cede ño Tags: Basic Research Source Type: research

Guest Editorial: Physician Guidance on the Use of Off ‐Labeled Drugs in Intrathecal Drug Delivery Systems for Chronic Pain
Neuromodulation: Technology at the Neural Interface, EarlyView. (Source: Neuromodulation: Technology at the Neural Interface)
Source: Neuromodulation: Technology at the Neural Interface - April 30, 2019 Category: Biotechnology Authors: Timothy Deer, Phillip Kim, Jason E. Pope, Salim Hayek, Gladstone McDowell, Nagy Mekhail, Sudhir Diwan, Michael Saulino, Susan Moeschler, David Schultz, Karina Gritsenko, Joshua Prager, Erika A. Peterson, Peter Staats, Lawrence Poree, Michae Tags: Letter to the Editor Source Type: research