Neuromodulation : journal of the International Neuromodulation Society
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Phantom limb pain (PLP) is a neuropathic condition in which pain is perceived as arising from an amputated limb. PLP is distinct from, although associated with, pain in the residual limb and nonpainful phantom sensations of the missing limb. Its treatment is extremely challenging; pharmaceutical options, while commonly employed, may be insufficient or intolerable. Neuromodulatory interventions such as spinal cord stimulation have generated mixed results and may be limited by poor somatotopic specificity. It was theorized that dorsal root ganglion (DRG) neuromodulation may be more effective. ⋯ DRG neuromodulation may be an effective tool in treating this pain etiology. Clinical outcomes in this report support recent converging evidence suggesting that the DRG may be the site of PLP generation and/or maintenance. Further research is warranted to elucidate mechanisms and optimal treatment pathways.
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The purpose of this pilot study was to determine the safety and feasibility of a six-day protocol of in-hospital repetitive peripheral magnetic stimulation combined with intensive swallowing rehabilitation (rPMS-ISR) for poststroke dysphagia. ⋯ The six-day in-hospital RPMS-ISR protocol seems safe and feasible for poststroke patients with dysphagia. The combination protocol improved swallowing function. Further larger studies are needed to confirm its efficacy.
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Computational modeling studies were performed to identify presynaptic elements of cortical neurons that are activated by subdural electrical stimulation. ⋯ This study examines the effects of subdural electrical stimulation on a high-density network consisting of several populations of multicompartment cell types. The effect of dendritic arbor structure on the axonal activation threshold is prominent in the case of multipolar neurons with large-diameter symmetric dendrites (basal/apical) that are oriented parallel to the electric field lines. The timing of presynaptic terminal activation after stimulation is not determined solely by the axonal delay (orthodromic propagation) but depends on the details of the applied stimulation field and axonal branching structure, which may be important factors in characterizing the effects of electrical stimulation in neuromodulation systems.
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The study aims to evaluate the long-term implant survival and complications of spinal cord stimulation (SCS) leading to surgical revision or explant in patients treated for chronic noncancer pain. ⋯ SCS is an effective treatment for chronic noncancer pain. It is a minimally invasive procedure, safe, and with good long-term outcomes. However, the surgical revision and explant rates are relatively high. As the use of SCS continues to grow, research into the causes of and risk factors for SCS-related complications is paramount to decrease complication rates in the future.
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The objective of this study is to investigate the efficacy of long-term follow-up of subcutaneous stimulation (SubQ) as an additional therapy for patients with failed back surgery syndrome (FBSS) with chronic refractory pain, for whom spinal cord stimulation (SCS) alone was unsuccessful in treating low back pain. ⋯ SCS combined with SubQ can be considered an effective long term treatment for low back pain in patients with FBSS for whom SCS alone is insufficient in alleviating their pain symptoms.