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Motor Cortex Stimulation in Patients Suffering from Chronic Neuropathic Pain: Summary of Expert Meeting and Premeeting Questionnaire, Combined with Literature Review.
World Neurosurg
December 2017
Department of Neurosurgery and Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium.
Background: Motor cortex stimulation (MCS) was introduced in the early 1990s by Tsubokawa and his group for patients diagnosed with drug-resistant, central neuropathic pain. Inconsistencies concerning the details of this therapy and its outcomes and poor methodology of most clinical essays divide the neuromodulation society worldwide into "believers" and "nonbelievers." A European expert meeting was organized in Brussels, Belgium by the Benelux Neuromodulation Society in order to develop uniform MCS protocols in the preoperative, intraoperative, and postoperative courses.
View Article and Find Full Text PDFReview: Bioelectrical mechanisms in spinal cord stimulation.
Neuromodulation
April 2015
Institute for Technical Medicine (MIRA), University of Twente, Enschede, The Netherlands.
Objectives: The aim of this review is to make specialists in a variety of disciplines familiar with basic aspects of spinal cord stimulation and the role of mathematical modeling in understanding its mechanisms of action and the solution of basic problems.
Methods: The paper is divided into five sections. The content of each section also covers aspects of various disciplines.
Performance of transverse tripoles vs. longitudinal tripoles with anode intensification (AI) in spinal cord stimulation: computational modeling study.
Neuromodulation
July 2014
MIRA, Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
Objective: In spinal cord stimulation, anodes tend to have a strong effect over the area of dorsal column (DC) activation, when configured as both longitudinal guarded cathodes (LGCs) and transverse tripoles (TTs). Inclusion of a small spacing step (LGC+) in the center-center (C-C) spacing of the LGC can be an efficient method to study the local effects around the electrode. The primary aim of this computer modeling study is to investigate if enhanced DC recruitment is achieved when anodal currents in TT and LGC combinations (both LGC and LGC+) are increased up to 30% with respect to the cathodal current.
View Article and Find Full Text PDFStaggered transverse tripoles with quadripolar lateral anodes using percutaneous and surgical leads in spinal cord stimulation.
Neurosurgery
March 2013
MIRA, Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
Background: In spinal cord stimulation for low-back pain, the use of electrode arrays with both low-power requirements and selective activation of target dorsal column (DC) fibers is desired. The aligned transverse tripolar lead configuration offers the best DC selectivity. Electrode alignment of the same configuration using 3 parallel percutaneous leads is possible, but compromised by longitudinal migration, resulting in loss of DC selectivity.
View Article and Find Full Text PDFExperimental spinal cord stimulation and neuropathic pain: mechanism of action, technical aspects, and effectiveness.
Pain Pract
February 2013
Department of Anaesthesiology and Pain Management, Pain Management and Research Centre, Maastricht University Hospital, Maastricht, The Netherlands.
Spinal cord stimulation (SCS) is a valuable treatment for chronic intractable neuropathic pain. Although SCS has gone through a technological revolution over the last four decades, the neurophysiologic and biochemical mechanisms of action have only been partly elucidated. Animal experimental work has provided some evidence for spinal as well as supraspinal mechanisms of neuropathic pain relief of SCS.
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