NeuromodulationPub Date : 2026-10-01Epub Date: 2026-10-05DOI: 10.1016/j.neurom.2026.06.031
Tariq M. Malik
{"title":"ID# 2176486 SUCCESSFUL NONSURGICAL MANAGEMENT OF CEREBROSPINAL FLUID LEAK FROM AN 11-GAUGE DURAL PUNCTURE: A CASE REPORT","authors":"Tariq M. Malik","doi":"10.1016/j.neurom.2026.06.031","DOIUrl":"10.1016/j.neurom.2026.06.031","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 7","pages":"Page e20"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149094024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NeuromodulationPub Date : 2026-10-01Epub Date: 2026-10-05DOI: 10.1016/j.neurom.2026.06.051
Daniel C. Roth DO, MBA, MS, Andrew Trobridge MD
{"title":"ID# 2187301 NONRECHARGEABLE IMPULSE GENERATOR LEADING TO INTOLERABLE PAIN SECONDARY TO DEVICE MALFUNCTION: A CASE REPORT","authors":"Daniel C. Roth DO, MBA, MS, Andrew Trobridge MD","doi":"10.1016/j.neurom.2026.06.051","DOIUrl":"10.1016/j.neurom.2026.06.051","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 7","pages":"Page e32"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NeuromodulationPub Date : 2026-09-28DOI: 10.1016/j.neurom.2026.09.012
Jakub Wiśniewski, Anna Barbara Marcinkowska, Piotr Stogowski, Stanisław Adamski, Wojciech Wasilewski
{"title":"Layered Mechanisms of Spinal Cord Stimulation for Chronic Pain: A Structured Narrative Review.","authors":"Jakub Wiśniewski, Anna Barbara Marcinkowska, Piotr Stogowski, Stanisław Adamski, Wojciech Wasilewski","doi":"10.1016/j.neurom.2026.09.012","DOIUrl":"https://doi.org/10.1016/j.neurom.2026.09.012","url":null,"abstract":"<p><strong>Objectives: </strong>Spinal cord stimulation (SCS) entered pain medicine through gate-control theory, but contemporary evidence no longer supports a single-mechanism explanation. This structured narrative review examines the mechanisms proposed for SCS in chronic pain beyond a single-gate explanation.</p><p><strong>Materials and methods: </strong>We conducted a SANRA-informed structured narrative review using predefined database searches, auditable deduplication, and a mechanistic coding framework. The search yield and deduplication counts were treated as audit data rather than as a PRISMA-style inclusion denominator. Ninety-eight sources were cited, comprising 95 historical, mechanistic, translational, clinical-inferential, or contextual references and 3 methodological references. No quantitative synthesis was performed.</p><p><strong>Results: </strong>The most mature mechanistic evidence, judged by the directness of the measured endpoint, supports the modulation of spinal nociceptive processing, including dorsal horn and spinothalamic output, wide-dynamic-range neuronal activity, wind-up, and inhibitory transmitter tone. ECAP-based systems improve the measurement and stabilization of neural recruitment, but recruitment fidelity should not be equated with analgesic mechanism. Waveform-specific claims are better interpreted as parameter-dependent perturbations of excitable tissue than as mechanisms defined by label. Most dorsal horn and neurochemical evidence was obtained with paresthesia-range tonic stimulation and therefore does not transfer automatically to paresthesia-free paradigms, which constrains how much of the older mechanistic literature can be applied directly. Supraspinal imaging, psychophysical, neuroimmune, and proteomic studies extend the mechanistic field, although many remain associative, model-dependent, or endpoint-specific. Vascular and cardiac autonomic findings are reported as non-analgesic effector-system physiology rather than as evidence for mechanisms of pain relief.</p><p><strong>Conclusions: </strong>SCS is better understood as a layered intervention than as a therapy governed by one explanatory mechanism. Target engagement, spinal processing, descending and supraspinal modulation, tissue-state change, and effector-system outcomes may each contribute under different conditions. Mechanistic claims should be indexed to the physiological endpoint that supports them rather than being inferred from device category or waveform terminology.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of Epidural Spinal Cord Stimulation on Poststroke Neurological Function: Institutional Experience and a Systematic Review.","authors":"Xiao-Liang Liu, Gui-Jun Zhang, Meng Jiang, Tong-Jiang Xu, Liang-Wen Zhang","doi":"10.1016/j.neurom.2026.09.015","DOIUrl":"https://doi.org/10.1016/j.neurom.2026.09.015","url":null,"abstract":"<p><strong>Objectives: </strong>The literature concerning clinical outcomes following treatment for poststroke hemiparesis (PSH) is relatively scarce. The objective of this study was to review the neurological outcomes after spinal cord stimulation (SCS) for PSH from a consecutive, single-institute, published series.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed a database of 10 patients diagnosed with PSH who underwent treatment with SCS at our single center between November 2023 and October 2025. The neurological evaluation included upper-extremity/lower-extremity modified Ashworth scale (MAS-UE/LE), UE/LE Fugl-Meyer assessment (FMA-UE/LE), Brunnstrom, Berg Balance Scale (BBS), and modified Barthel index (MBI) scores before treatment and during follow-up. The references of the publications meeting the inclusion criteria were checked again for eligibility using PubMed and Embase. A paired t-test was used to compare changes in neurological outcomes before and after treatment.</p><p><strong>Results: </strong>A total of 10 PSH patients (90.0%, 9 males and 10.0%, 1 female) were eligible for inclusion in the analysis, with a mean age at the time of the SCS treatment of 50.9 ± 3.8 years (range 34.0-69.0 years). The mean MAS-UE, MAS-LE, FMA-UE, FMA-LE, Brunnstrom, BBS, and MBI scores were 3.0 ± 0.9, 2.8 ± 0.7, 13.4 ± 9.3, 9.9 ± 6.5, 3.1 ± 0.7, 39.5 ± 15.2, and 85.3 ± 32.8, respectively, at admission and 2.2 ± 1.0 (95% CI=0.5-1.1; p < 0.001), 2.0 ± 0.8 (95% CI=0.5 -1.1; p < 0.001), 23.4 ± 9.8 (95% CI = -13.6--6.4 ; p < 0.001), 14.4 ± 7.3 (95% CI=-6.4--2.7; p = 0.001), 4.1 ± 0.7 (95% CI=-1.3--0.7; p < 0.001), 42.9 ± 15.6 (95% CI=-6.0--0.8; p = 0.016), and 87.5 ± 33.1 (95% CI = -3.8 --0.6; p = 0.013), respectively, at 3 months of follow-up. Six published reports with 32 patients were included in this study, and no significant differences were found in baseline characteristics between our cohort and published studies.</p><p><strong>Conclusion: </strong>The use of SCS to treat patients with PSH results in improved function with acceptable long-term feasibility.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149271346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}