New Horizons in Neuromodulation
- 344 Downloads
Electrical stimulation of the nervous system is a method used for several centuries which just in the past decades received wide recognition as an effective and safe modality in the management of neuropathic pain and other maladies. Explosion of new technologies and discovery of new neuromodulation targets are two parallel and interconnected processes. Using a paraphrase from the famous novel of Samuel Sham, The House of God, one can say that there is no nervous tissue in the human body that cannot be reached with a stimulating lead directed by a good strong arm. Neuromodulation devices are being used for the stimulation of the entire nervous system, from the cutaneous terminals to brain centers. Autonomic regulation is also subject to stimulation via implanted devices. Future research and development is tightly related to the process of discovery, experimental courage, and philosophical exploration of neurobehavioral mechanisms.
KeywordsNeurostimulation Neuromodulation Electrical Stimulation Nervous System
Compliance with Ethics Guidelines
Conflict of Interest
Dr. Gofeld is a consultant for Medtronic Inc., St. Jude Medical, and Boston Scientific (Cardiovascular Division), and has received grants from St. Jude Medical in the past. Dr. Gofeld serves as a section editor for Current Pain and Headache Reports.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 3.•Younger JW, Chu LF, D’Arcy N, Trott K, Jastrzab LE, Mackey SC. Prescription opioid analgesics rapidly change the human brain. Pain. 2011;152(8):1803–10. The results of this study suggest that even short-term administration of opioids may irreversibly change brain gray matter in certain regions including the amygdala, hypothalamus, inferior frontal gyrus, ventral posterior cingulated, and caudal pons.PubMedCentralPubMedCrossRefGoogle Scholar
- 8.•Kumar K, Rizvi S, Nguyen R, et al. Impact of wait-times on spinal cord stimulation therapy outcomes. Pain Pract 2013. This paper illustrates how the long-term efficacy of SCS is inversely proportional to implantation delay. The key to success is early SCS implantation and adherence to rigorous patient selection. Google Scholar
- 9.http://www.marketsandmarkets.com/Market-Reports/neurostimulation-devices-market-921.html. Last accessed October 2013
- 10.Ansarinia M, Rezai A, Tepper SJ, Steiner CP, Stump J, Stanton-Hicks M, et al. Electrical stimulation of sphenopalatine ganglion for acute treatment of cluster headaches. Headache. 2010;50(7):1164–74.Google Scholar
- 11.Schoenen J, Jensen RH, Lantéri-Minet M, Láinez MJ, Gaul C, Goodman AM, et al. Stimulation of the sphenopalatine ganglion (SPG) for cluster headache treatment. Pathway CH-1: A randomized, sham-controlled study. Cephalalgia. 2013;33(10):816–30.Google Scholar
- 13.Liem L, Russo M, Huygen FJ, Van Buyten JP, Smet I, Verrills P, et al. A multicenter, prospective trial to assess the safety and performance of the spinal modulation dorsal root ganglion neurostimulator system in the treatment of chronic pain. Neuromodulation. 2013. doi: 10.1111/ner.12072.