Neuromodulation : journal of the International Neuromodulation Society
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This study aimed to assess the influence of preoperative cognition on postoperative motor and nonmotor outcomes in patients with Parkinson disease (PD) after deep brain stimulation (DBS). ⋯ DBS induces a clinically meaningful motor improvement in patients with cognitive impairment and PD, but the improvement may be smaller than in patients who are not cognitively affected. Further research into the risk-benefit balance of DBS in people with PD and cognitive dysfunction is warranted.
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During the last decade, the complementary value of real-world data (through registries or medical records) and data from randomized clinical trials has been recognized as increasingly important. In the field of neuromodulation, only a few industry-independent nationwide neuromodulation registries are available. The interest in creating a European registry has increased but without a successful result. The goal of this online survey is to gain further insights into the need for and burden of a European registry for neuromodulation. ⋯ More than 90% of the respondents believed that a European registry for neuromodulation is needed, mainly to obtain real-world (big) data about the effectiveness and safety of this therapy. This survey clearly pointed to the need for a European registry for which it seems key to ensure financial and logistical support, in addition to in-depth legal guidance in developing this registry.
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Repetitive transcranial magnetic stimulation (rTMS) has shown promising results in enhancing motor recovery after stroke, but nuances regarding its use, such as the impact of the type and site of stimulation, are not yet established. We aimed to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) with low risk of bias to investigate the effect of rTMS on motor recovery after both ischemic and hemorrhagic stroke. ⋯ Current literature supports the use of rTMS for motor recovery after stroke, especially when done within six months and for patients with more severe stroke at baseline. Future studies with larger sample sizes may be helpful in clarifying the potential of rTMS in poststroke rehabilitation.
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Chronic low back pain (CLBP) is often associated with impaired motor control and degeneration of the lumbar multifidus muscles. Several studies have reported on the utility of multifidus or medial branch stimulation as a treatment. We present a systematic review and meta-analysis of studies reporting on the change in low back pain intensity with multifidus stimulation. ⋯ Medial branch stimulation for the treatment of CLBP shows a high probability of a clinically significant change in pain intensity. Longer duration of stimulation was associated with decreased low back pain intensities.
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The multicenter, randomized, double-blinded, active-sham controlled trial (high-freQUEncy nerve block for poST amputation pain [QUEST]) was conducted to show the safety and efficacy of a novel, peripherally placed high-frequency nerve block (HFNB) system in treating chronic postamputation pain (PAP) in patients with lower limb amputations. The primary outcomes from QUEST were reported previously. This study presents the long-term, single-cross-over, secondary outcomes of on-demand HFNB treatment for chronic PAP. ⋯ Overall, HFNB delivered directly to the damaged peripheral nerve provided sustained, on-demand relief of acute PAP exacerbations, reduced opioid utilization, and improved QOL for patients with lower limb amputations with chronic PAP.