Neuromodulation : journal of the International Neuromodulation Society
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Pre-operative psychological assessment is commonly used to assess patients for spinal cord stimulation (SCS). Though often times mandated by insurance, its value is frequently questioned. ⋯ The predictive value of psychological testing depends on which psychiatric factors are used and which outcomes are measured. The predictive capacity of psychological indications can be used to holistically treat patients, specifically to recommend psychiatric medication and consulting to supplement SCS treatment as needed.
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Spinal Cord Stimulator (SCS) is a surgically implanted device for patients with certain types of chronic pain. While some studies show the value of psychological screening of potential SCS candidates, no consensus exists. This single-site study analyzed the association of SCS success with psychological assessments (e.g., Millon Behavioral Medicine Diagnostic), beliefs regarding SCS efficacy, self-reported pain and quality of life (QOL) among patients approved for SCS. ⋯ Predictors of pain relief and QOL following SCS may depend on expectations of the device and on individuals' interpretation of pain or psychosocial health.
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Electrical stimulation of the hippocampus offers the possibility to treat patients with mesial temporal lobe epilepsy (MTLE) who are not surgical candidates. We report long-term follow-up results in five patients receiving low or high frequency hippocampal stimulation for drug-resistant MTLE. ⋯ Electrical stimulation of the hippocampus is a minimally invasive and reversible method that can improve seizure outcomes in patients with drug-resistant MTLE. The optimal frequency of stimulation varied from patient to patient and therefore required individual setting. These experimental results warrant further controlled studies with a large patient population to evaluate the long-term effect of hippocampal stimulation with different stimulation parameters.
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To report a case with two years follow-up of neuropathic pain and functional limitations associated with multiple sclerosis (MS) effectively treated with an MRI conditional spinal cord stimulator (SCS) system that allowed for spinal imaging. To present a comprehensive literature review of spinal cord stimulator utilization in the treatment of multiple sclerosis. ⋯ We report the successful treatment of MS-associated pain and functional limitations with an MRI conditional spinal cord stimulator system. The ability to obtain post-implant MRI imaging of not only the brain but also the spinal cord in MS patients allows for the continued need to document and follow disease progression, especially with the advancements in pharmacological therapy.
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Traditional tonic spinal cord stimulation (SCS) has been approved by FDA for chronic pain of intractable back and limb pain. However, it induces paresthesia and relieves pain poorly to some extent. Recently, burst SCS has been developed for pain reduction without the mandatory paresthesia. ⋯ Burst SCS is a new approach that possibly causes more pain reduction for short-term duration than tonic SCS without eliciting paresthesia. The evidence based on this systematic review for burst SCS in treating chronic intractable pain is considered fair and limited. This is an AAN recommendation level U. Further research is needed with a larger sample size and a standardized study design.