Neuromodulation最新文献

{"title":"Vagal Nerve Stimulation for Chronic Constipation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Ahmad Omar Saleh MD,&nbsp;Ameer Awashra MD,&nbsp;Alaa Abdrabou Abouelmagd MD,&nbsp;Mostafa Elkholy MBBCh,&nbsp;Ekram Hassan Hasanin MBBCh,&nbsp;Abd alrahman Alsabbagh Aldohni MBBCh,&nbsp;Ismail Elkhattib MD,&nbsp;Mohamed Abuelazm MBBCh,&nbsp;Mohamed Elnaggar MD","doi":"10.1016/j.neurom.2026.01.005","DOIUrl":"10.1016/j.neurom.2026.01.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic constipation is a prevalent and heterogeneous disorder, affecting approximately 10% to 14% of adults and significantly influencing quality of life. Neuromodulation has been explored as a potential treatment; however, evidence remains limited. Therefore, this meta-analysis of randomized controlled trials (RCTs) aims to assess the efficacy and safety of vagus nerve–based neuromodulation techniques for chronic constipation, specifically transcutaneous auricular vagus nerve stimulation (taVNS) and transcutaneous electroacupuncture (TEA).</div></div><div><h3>Materials and Methods</h3><div>A comprehensive search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was performed from inception to June 2025. Data were pooled using risk ratios for dichotomous outcomes and mean differences (MD) or standardized mean differences (SMD) for continuous outcomes, with 95% CIs, applying a random-effects model. Statistical analyses were conducted using R (version 4.4.2) in R-Studio, International Prospective Register of Systematic Reviews identification: (CRD420251132888).</div></div><div><h3>Results</h3><div>Six RCTs involving 356 participants were included. Vagal nerve stimulation (VNS) significantly improved the visual analog pain scale (MD: −1.76 [95% CI: −2.92 to −0.60], <em>p</em> = 0.003), Bristol stool form scale (BSFS) (MD: 0.99 [95% CI: 0.30–1.68], <em>p</em> = 0.005), weekly spontaneous bowel movements (SBM) frequencies (MD: 1.75 [95% CI: 0.93–2.58], <em>p</em> &lt; 0.0001), weekly complete spontaneous bowel movements (CSBM) frequencies (MD of 1.10 [95% CI: 0.40–1.80]), <em>p</em> = 0.002), and irritable bowel syndrome symptom severity (IBS-SSS) score (SMD of −1.68 [95% CI: −3.13; −0.24], <em>p</em> = 0.023). Still, there was no significant difference between the groups regarding Self-Rating Anxiety Scale (MD: −1.84 [95% CI: −6.19 to 2.52], <em>p</em> = 0.41), Self-Rating Depression Scale (SDS) scores (MD: −2.06 [95% CI: −6.14 to 2.02], <em>p</em> = 0.32), and anorectal function (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>VNS substantially improves VAS, BSFS, weekly SBM, weekly CSBM, and IBS-SSS scores.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 7","pages":"Pages 1079-1090"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317855","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":"The Safety and Efficacy of Gastric Electrical Stimulation During Pregnancy in Patients With Medically Refractory Gastroparesis: Observations From a Multicenter Case Series","authors":"Josh McGovern MBChB, PhD,&nbsp;Stephen Leadbitter MBChB,&nbsp;Morven Findlay MBChB,&nbsp;Adil Shafi MBChB,&nbsp;Oluwafemi Coker BMBS, MSc,&nbsp;Gillian Rice BA,&nbsp;Paul Glen MBChB, MD","doi":"10.1016/j.neurom.2025.12.012","DOIUrl":"10.1016/j.neurom.2025.12.012","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to determine the safety and efficacy of gastric electrical stimulation (GES) in pregnant patients with medically refractory gastroparesis (GP).</div></div><div><h3>Materials and Methods</h3><div>Prospectively collected data from female patients with medically refractory GP who underwent implantation of a neurostimulator for GES within National Health Service Greater Glasgow and Clyde, between March 2009 and January 2024, were retrospectively analyzed. The primary outcomes of interest were the number of admissions to hospital with nausea and vomiting (N&amp;V) across each trimester and the incidence of fetal and maternal complications during and after delivery.</div></div><div><h3>Results</h3><div>Seven pregnancies were reported by six patients. The median age of patients during pregnancy was 27.5 years (26–29). Of these patients, 71% (<em>n</em> = 5) had diabetic GP. The median number of admissions to hospital with N&amp;V during pregnancy was two (one–four), with the number of admissions to hospital reducing as the pregnancy progressed (nine admissions during first trimester vs six during the second vs one admission during the third). The median pregnancy term was 33 weeks (28–38), with 71% (<em>n</em> = 5) of pregnancies preterm. The mode of delivery was a cesarean birth in 86% of patients (<em>n</em> = 6), with two performed as emergencies. One patient had a postpartum hemorrhage, and another required admission to the intensive care unit because of renal failure after emergency cesarean birth. There were no maternal mortalities within 30 days of pregnancy. The median fetal birth weight was 1700 g (660–2930). One infant (14%) required admission to a level 3 neonatal intensive care unit owing to an underlying cardiac malformation and subsequently died six weeks after delivery.</div></div><div><h3>Conclusion</h3><div>The incidence of admission to hospital with N&amp;V reduced with progression of the pregnancy in patients with medically refractory GP. Although all pregnancies ended in a live birth, the safety of GES therapy during pregnancy remains unclear and requires further study.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 7","pages":"Pages 1249-1253"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insurance Authorizations in Pediatric Disorders of Gut–Brain Interaction Treated With Auricular Neuromodulation: A Tertiary Center Experience","authors":"Mohamad Abi Nassif MD,&nbsp;Khalil El-Chammas MD,&nbsp;Kahleb Graham MD,&nbsp;Rashmi D. Sahay MD,&nbsp;Jennifer Hardy BA,&nbsp;Abdul Rahim Dahman MD,&nbsp;Neha R. Santucci MD, MBBS, MS","doi":"10.1016/j.neurom.2026.07.644","DOIUrl":"10.1016/j.neurom.2026.07.644","url":null,"abstract":"<div><h3>Objectives</h3><div>Auricular percutaneous electrical nerve field stimulation (PENFS) is a Food and Drug Administration-approved treatment for functional abdominal pain associated with irritable bowel syndrome and functional dyspepsia. Because PENFS is relatively new, insurance coverage has been inconsistent, with patients experiencing denials or delays in authorization. Thus, we aimed to evaluate insurance authorizations and their influence on outcomes in children with disorders of gut-brain interaction (DGBI) who undergo PENFS.</div></div><div><h3>Materials and Methods</h3><div>We reviewed charts of patients with DGBI aged seven to 21 years receiving PENFS at the DGBI Clinic at Cincinnati Children's Hospital from 2017 to 2024. We computed the duration of insurance authorization steps to treatment, divided the cohort into early and delayed authorization groups, and assessed outcomes on the basis of collected validated questionnaire scores.</div></div><div><h3>Results</h3><div>Among 309 patients (median age 15 years; 78% female; 90% Caucasian), 75% had private and 25% public insurance. Prior authorization (PA) was not required in 55% of cases, whereas 18% were initially approved and 27% denied. Overall, 70% of patients were approved and 30% were denied after completion of the insurance process. Private insurers were more likely to deny PA than public ones (29% vs 21%, <em>p</em> = 0.003). Kaplan-Meier analysis showed significantly longer time to approval for those denied coverage (<em>p</em> &lt; 0.001). Outcomes based on validated questionnaire scores did not differ between early and delayed insurance groups at the final PENFS placement visit (<em>p</em> &gt; 0.05 for all).</div></div><div><h3>Conclusion</h3><div>Private insurance denials are significantly more common than public, creating disparity in availability of PENFS treatment for this group of patients with complex conditions. The timing of insurance denials can lead to delayed treatment, providing less than optimal patient care.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 7","pages":"Pages 1269-1276"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ID# 2171332 RADIOFREQUENCY ABLATION OUTCOMES FOR CHRONIC LOW BACK PAIN USING A NEW CANNULA WITH DEPLOYMENT DESIGN","authors":"Simon Bayerl MD,&nbsp;Georgios Kyriakopoulos MD,&nbsp;Maria L. Padilla del Rey MD","doi":"10.1016/j.neurom.2026.06.017","DOIUrl":"10.1016/j.neurom.2026.06.017","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 7","pages":"Page e11"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149094306","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":"High-Frequency Gastric Electrical Stimulation Selectively Remodels Nitrergic Neurons in the Gastric Antrum of Healthy Beagles","authors":"Bo Huang MB,&nbsp;Mingyu Fu MS,&nbsp;Heer Yang MB,&nbsp;Xueqian Yang MB,&nbsp;Xin Wu MD,&nbsp;Yang Zhao MD,&nbsp;Guijun Fei MD,&nbsp;Jianing Li MD,&nbsp;Chunhua Hu PhD,&nbsp;Pan Tang MS,&nbsp;Xiucai Fang MD","doi":"10.1016/j.neurom.2026.04.013","DOIUrl":"10.1016/j.neurom.2026.04.013","url":null,"abstract":"<div><h3>Objectives</h3><div>The study aimed to investigate the effects and mechanisms of high-frequency short-pulse gastric electrical stimulation (GES) on gastric emptying and specific myenteric neurons of the gastric antrum in healthy beagle dogs.</div></div><div><h3>Materials and Methods</h3><div>Four healthy adult dogs were implanted with gastric electrical devices, randomly divided into two groups, and given high-frequency short-pulse GES and sham GES (SGES) separately for four weeks in a crossover design, with a three-week washout period. The GES parameters were set 5 mA, 15 Hz, 0.33 ms, cycle on 0.2 s and off 3 s, and the SGES group received no stimulation. Food and water intake, body weight, and gastric emptying scintigraphy were evaluated before and after stimulation. The total neurons, choline acetyltransferase (ChAT), vasoactive intestinal peptide (VIP), neuronal nitric oxide synthase (nNOS), and calretinin (CALR)-immunoreactivity (IR) positive neurons were measured by indirect immunofluorescence double staining in the gastric antral specimens.</div></div><div><h3>Results</h3><div>After four weeks of GES, dogs were shown significantly higher relative food intake and water intake, along with greater median weight gain compared with the SGES group. GES produced no significant effect on gastric emptying. The total number of antral myenteric neurons in full-thickness biopsies remained comparable between two groups; the proportion of nNOS-IR neurons was significantly higher in GES group than in SGES group (34.9% ± 1.7% vs 27.8% ± 1.9%, <em>p</em> = 0.004). Conversely, the proportion of VIP-IR neurons was lower in GES group than in SGES group (62.5% ± 1.5% vs 65.0% ± 1.8%, <em>p</em> = 0.019). No significant differences were observed in the proportions of ChAT-IR or CALR-IR neurons.</div></div><div><h3>Conclusions</h3><div>High-frequency short-pulse GES selectively increased the proportion of gastric nitrergic (nNOS-IR) neurons and improved feeding tolerance without altering gastric emptying in healthy dogs. This finding indicates that inhibitory nitrergic neuronal remodeling constitutes a key mechanism underlying GES, probably enhancing gastric accommodation.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 7","pages":"Pages 1191-1199"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252584","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":"Patients With Gastroparesis Symptoms After Gastric Electrical Stimulation With and Without Tube Feedings","authors":"Fares Kasem DO,&nbsp;Le Yu Naing MD,&nbsp;Prateek Mathur MD,&nbsp;Lindsay McElmurray PA-C,&nbsp;Carmelita Moppins APRN,&nbsp;Michael W. Daniels MS,&nbsp;Abigail Stocker MD,&nbsp;Thomas L. Abell MD,&nbsp;Endashaw Omer MD","doi":"10.1016/j.neurom.2025.07.008","DOIUrl":"10.1016/j.neurom.2025.07.008","url":null,"abstract":"<div><h3>Background</h3><div>Patients with gastroparesis tend to consume a less nutritious, high–simple-carbohydrate diet because it is better tolerated than a regular diet with an optimal composition of carbohydrates, protein, and fat. The effect of gastric electrical stimulation (GES) on the nutritional status of patients with drug-refractory gastroparesis (Gp) is unclear when patients are receiving jejunostomy tube (J-tube) feedings. We conducted a prospective, nonrandomized, open-label study to investigate and compare the effects of GES in patients with and without J-tubes.</div></div><div><h3>Materials and Methods</h3><div>We examined 311 patients with Gp symptoms (Sx) (54 men, 257 women, mean age 44 years, with the following diagnoses: 183 idiopathic, 89 diabetes, 39 postsurgical) for baseline characteristics and outcomes at one year after GES with or without J-tube feedings. The primary end point of this study is relief of nausea, vomiting, and upper gastrointestinal (GI) Sx. Secondary end points include improvement in tolerability of a regular diet and a decrease in tube feeding use.</div><div>Patients were profiled by GI Sx, nutritional status, weight, and quality of life at baseline and after one year based on their use of tube feeding (TF) or not, and their Sx from baseline to one-year follow-up. The two groups were then further categorized as Improved (IMP) or Not Improved (nIMP) in post hoc analysis to evaluate interactions across the four groups.</div></div><div><h3>Results</h3><div>Our findings indicate significant alleviation of nausea, vomiting, and upper GI Sx. GES was tolerated in patients with and without a J-tube. Patients in both treatment arms experienced considerable improvement and tolerability of a regular diet.</div></div><div><h3>Conclusion</h3><div>From this large sample size in patients with Gp Sx, with and without J-tube TF, patients in both groups had similar responses to the bio-electric therapy of GES. From these data, the J-tube is not a contraindication to GES; patients with GES can maintain their weight with or without a J-tube. Further work with feeding tubes and GES is indicated.</div></div><div><h3>Clinical Trial Registration</h3><div>The <span><span>Clinicaltrials.gov</span><svg><path></path></svg></span> registration number for the GOLDEN study is NCT03876288.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 7","pages":"Pages 1229-1241"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145636846","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":"A Retrospective Analysis of Sacral Neuromodulation for Vesicoureteral Reflux in Neurogenic Bladder: Outcomes and Predictors","authors":"Guoqing Chen MD, PhD,&nbsp;Peng Zhang MD, PhD,&nbsp;Fan Zhang MD, PhD,&nbsp;Yanhe Ju MD,&nbsp;Haichao Liu MD,&nbsp;Baihui Wang MD,&nbsp;Fei Zhou MD,&nbsp;Limin Liao MD, PhD","doi":"10.1016/j.neurom.2026.04.022","DOIUrl":"10.1016/j.neurom.2026.04.022","url":null,"abstract":"<div><h3>Objectives</h3><div>This retrospective study aimed to evaluate the long-term efficacy of sacral neuromodulation (SNM) in managing vesicoureteral reflux (VUR) secondary to neurogenic lower urinary tract dysfunction (NLUTD) and identified predictors of success.</div></div><div><h3>Materials and Methods</h3><div>A total of 26 patients with NLUTD and urodynamically confirmed VUR(21 unilateral, 5 bilateral) underwent SNM test stimulation. Video-urodynamic studies assessed VUR grade, safe bladder capacity, and detrusor pressure pre- and posttest. Success criteria were as follows: VUR reduced to grade I or lower or VUR still grade II or higher but with delayed onset of reflux and safe bladder capacity clinically judged to be suitable for clean intermittent catheterization (CIC). Patients with success proceeded to permanent implantable pulse generator placement, with annual follow-up.</div></div><div><h3>Results</h3><div>During the test phase (mean 27.9 days), VUR resolved in 13 of 31 refluxing ureters. Safe bladder capacity significantly increased (119.7 ± 18.0 mL to 240.9 ±2 1.3 mL, <em>p</em> &lt; 0.05) and maximum detrusor pressure during the storage phase decreased (45.0 ± 6.9 to 31.0 ± 5.9 cmH₂O, <em>p</em> &lt; 0.05). A total of 21 patients received permanent implants. In 13 patients with long-term follow-up (1–4 years), VUR resolved in five patients who had persistent reflux post-test, whereas recurrence occurred in two patients. Multivariate analysis identified pretreatment VUR grade as the only significant predictor of success (odds ratio = 0.30; <em>p</em> &lt; 0.05), with higher grades associated with lower odds of resolution.</div></div><div><h3>Conclusions</h3><div>SNM can improve or resolve VUR in select patients with NLUTD by enhancing bladder compliance and reducing storage pressure. Higher baseline VUR grade predicts a lower likelihood of success. Long-term success requires adherence to CIC.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 7","pages":"Pages 1285-1291"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217940","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":"Efficacy and Safety of Intravesical Electrical Stimulation for Underactive Bladder: A Meta-Analysis and Systematic Review","authors":"Hao Yu MD,&nbsp;Zheng Duan MD,&nbsp;Jiayin Sun MD,&nbsp;Zongyao Fan MD, PhD,&nbsp;Junjie Zhang MD, PhD,&nbsp;Zhengsen Chen MD,&nbsp;Pengyu Wang MD,&nbsp;Zhongqing Wei MD, PhD","doi":"10.1016/j.neurom.2025.10.059","DOIUrl":"10.1016/j.neurom.2025.10.059","url":null,"abstract":"<div><h3>Background</h3><div>Underactive bladder (UAB) can lead to urinary retention and kidney damage, severely affecting patients' health. Currently, there are insufficient effective treatments. Some studies suggest that intravesical electrical stimulation (IVES) may relieve symptoms in patients with UAB, but its efficacy remains uncertain. This study aims to explore the effectiveness of IVES and provide guidance for clinical decision-making.</div></div><div><h3>Materials and Methods</h3><div>On the basis of the search keywords, we searched PubMed, Web of Science, Cochrane Library, and Embase data bases up to January 20, 2025 and screened studies according to the inclusion and exclusion criteria. We extracted urodynamic and symptom assessment indicators from eligible studies, calculated pooled mean differences (MDs) and 95% CIs, and validated results using subgroup and sensitivity analyses. Publication bias was assessed using funnel plots and Egger's test.</div></div><div><h3>Results</h3><div>Six studies with 310 patients were included. The pooled results showed postvoid residual urine volume (PVR) had a significant improvement (MD = −108.7 mL, 95% CI: −177.69; −39.71). The secondary outcomes, including voided volume, urine flow rate, voiding efficiency, and 24-hour clean intermittent catheterization first sensation capacity, were assessed. Among these, both voided volume (MD = 86.66 mL, 95% CI: 1.56; 171.77) and voiding efficiency (MD = 30.72%, 95% CI: 21.95; 39.49) showed improvement in patients who received IVES compared with those who did not. The most common adverse event was urinary tract infection, with no severe adverse events reported.</div></div><div><h3>Conclusions</h3><div>IVES might be effective in reducing PVR, increasing voided volume, and improving voiding efficiency in patients with UAB, and is a safe, minimally invasive, and simple treatment option. It can be considered as a treatment choice for UAB, although this conclusion still needs to be verified by large-scale and high-quality clinical studies.</div></div><div><h3>International Prospective Register of Systematic Reviews Registered ID</h3><div>CRD420251011794</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 7","pages":"Pages 1139-1145"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669183","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":"A Systematic Review of Gastrointestinal Changes Related to Spinal Cord Stimulation","authors":"Haiyue Jin BS,&nbsp;Arthur W. Cowman BS,&nbsp;Ramanjit Singh MS,&nbsp;George Habib BS,&nbsp;Tarika Gujral BS,&nbsp;Kimia Heidari BS,&nbsp;Will M. Lee BS,&nbsp;Noah M. Ross HS,&nbsp;Seyedshayan Shojaei BS,&nbsp;Veronica Lubera BS,&nbsp;Micah Tratt BS,&nbsp;Hao-Hua Wu MD,&nbsp;Michael Y. Oh MD","doi":"10.1016/j.neurom.2026.07.649","DOIUrl":"10.1016/j.neurom.2026.07.649","url":null,"abstract":"<div><h3>Objectives</h3><div>Although spinal cord stimulation (SCS) is an established neuromodulatory therapy for chronic pain, its gastrointestinal (GI) effects beyond analgesia remain poorly characterized. This study synthesized the current evidence describing nonpain GI changes associated with permanent SCS implantation.</div></div><div><h3>Materials and Methods</h3><div>A systematic search of PubMed, Web of Science, and Scopus was conducted on April 25, 2025, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. Studies describing permanent SCS implantation with percutaneous or paddle leads in patients with baseline GI complaints and/or inducing GI changes were included. Animal models, reviews, and nonpermanent trial-only stimulations were excluded. The Oxford Centre for Evidence-Based Medicine hierarchy, study-design-specific methodologic quality assessments, and the Grading of Recommendations Assessment, Development, and Evaluation framework were used to assess study quality. Study characteristics, patient demographics, lead placement, stimulation paradigms, and GI outcomes were extracted. Nonpain GI effects were categorized as desired or undesired on the basis of the clinical direction of change relative to baseline.</div></div><div><h3>Results</h3><div>Overall, 21 studies comprising 143 patients were included, predominantly comprising case reports/series, along with two retrospective cohort studies, two prospective single-arm studies, and one randomized cross-over pilot trial. Most SCS implantations were performed for abdominal or visceral pain (88.8%). Thoracic lead placement was most common (69.2%), and 10-kHz stimulation was the predominant paradigm (46.2%). A total of 86 desired GI changes and 13 undesired GI changes were reported. The most frequent desired effects were decreased nausea (32.6%) and reduced diarrhea (12.8%), whereas worsened nausea (23.1%) was the most common adverse effect, followed by diarrhea (15.4%) and constipation (15.4%).</div></div><div><h3>Conclusions</h3><div>GI changes have been identified with SCS use, most commonly improvements in nausea and bowel function, although adverse effects have been reported. Current evidence remains limited by heterogeneity and low certainty, highlighting the need for controlled studies with standardized GI outcome measures.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 7","pages":"Pages 1067-1078"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ID# 2185772 THE POTENTIAL ROLE OF PERIPHERAL NERVE STIMULATION FOR FOCAL CANCER PAIN IN PATIENTS IN HOSPICE","authors":"Casey Barry MD,&nbsp;Matthew Chung MD","doi":"10.1016/j.neurom.2026.06.047","DOIUrl":"10.1016/j.neurom.2026.06.047","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 7","pages":"Page e30"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095393","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}