Neuromodulation : journal of the International Neuromodulation Society
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In a bladder overactivity model of cystitis induced by intravesical infusion of acetic acid (a.a.), several parameters of spinal nerve stimulation (SNS) were optimized using continuous infusion cystometry. The optimal stimulation was further characterized through measurements of urodynamic function using single-fill cystometry. ⋯ SNS significantly attenuates hypersensitive micturition reflex; 10 Hz and high-intensity stimulation are mostly effective. Acute peripheral nerve activation increases the functional bladder capacity, which may be via mechanisms on the afferent arm of the bladder micturition reflex.
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Spinal cord stimulation (SCS) has been proven effective for multiple chronic pain syndromes. Over the past 40 years of use, the complication rates of SCS have been well defined in the literature; however, the incidence of one of the most devastating complications, spinal cord injury (SCI), remains largely unknown. The goal of the study was to quantify the incidence of SCI in both percutaneous and paddle electrode implantation. ⋯ Our study shows that the overall incidence of SCI in SCS is low (2.13%), supporting that SCS is a safe procedure. No significant difference was found in the rates of SCI or spinal hematoma between the percutaneous and paddle groups. Further studies are needed to characterize the mechanisms of SCI in SCS and long-term outcomes in these patients.
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Recent studies suggest that oscillatory beta activity could be used as a state biomarker in patients with Parkinson's disease for subthalamic closed-loop stimulation with the intention of improving clinical benefit. Here we investigate the feasibility of subthalamic recordings via a novel chronically implanted pulse generator. ⋯ The results of the study suggest that oscillatory beta band synchronization and its modulation by DBS is recordable with a system suitable for chronic implantation and may serve as a biomarker for subthalamic closed-loop stimulation in patients with Parkinson's disease.
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To investigate the association between socioeconomic status and deep brain stimulation (DBS) outcomes in Parkinson's disease (PD). ⋯ PD patients with higher household incomes had better functional improvement at one year. However, this did not necessarily translate to better quality of life or overall clinical improvement when compared with PD patients with lower household incomes. The influence of household income on DBS and other advanced therapies for PD will need further investigation.
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Surgical site infections (SSIs) are associated with significant healthcare costs and morbidity. Limited research exists specific to the prevention of spinal cord stimulation (SCS) SSIs. The objectives of this international survey were to examine current infection control practices for SCS trials and implants and to compare reported responses with evidence-based recommendations. ⋯ The survey provided significant insight into current practices and will assist in the development of specific SCS infection control policies. Based on the survey, further education is warranted on infection control strategies for physicians performing spinal cord stimulator trials and implants.