Neuromodulation最新文献

{"title":"Evaluation of a Miniature, Injectable, Wireless Stimulator to Treat Obstructive Sleep Apnea","authors":"Andrew J. Fuglevand PhD ,&nbsp;E. Fiona Bailey PhD ,&nbsp;Tarek Makansi PhD","doi":"10.1016/j.neurom.2024.11.009","DOIUrl":"10.1016/j.neurom.2024.11.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Moderate-to-severe obstructive sleep apnea (OSA) affects a large segment of the US population and is characterized by repetitive and reversible obstruction of the upper airway during sleep. Untreated OSA is associated with increased incidence of heart attack, stroke, and motor vehicle accidents due to sleepiness. Continuous positive airway pressure is often prescribed, but most patients with OSA are nonadherent. One effective alternative is stimulation of the hypoglossal nerve (HGN) that acts to open and stiffen the airway. However, currently available HGN stimulators require major surgery to implant a pacemaker-like device and leads that connect to a cuff electrode encircling the HGN. In this study, we performed preliminary tests in rats and humans of a miniature stimulating device that, in the future, could be injected near the HGN with ultrasound guidance.</div></div><div><h3>Methods and Results</h3><div>This device (1 × 9 mm) is activated wirelessly using a small wearable (3.5-cm diameter) that would be placed on the skin under the jaw in human patients. The system was effective in robustly activating the rat sciatic nerve at distances up to 2.5 cm from the wearable. Furthermore, the device delivered through injection could fully activate the rat sciatic nerve if placed at distances &lt;4 mm from the nerve. The extent of migration of the device measured in seven rats over a one-month period was not significant for most injectables, but six of 18 did change position (mainly along the injection path). We discuss strategies for minimizing migration in the future. Lastly, we report on tests in one awake human subject, wherein wireless stimulation of the HGN caused &gt;60% increase in airflow during inspiration.</div></div><div><h3>Conclusion</h3><div>Collectively, these initial experiments encourage future studies to determine the utility of this system in alleviating OSA in human subjects.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Pages 580-591"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896257","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":"Tracking and Failure Analysis of Explanted Neuromodulation Devices","authors":"Institute of Neuromodulation Device Disposition Committee,&nbsp;Tess L. Veuthey MD, PhD ,&nbsp;Deborah Duricka PhD ,&nbsp;Dario J. Englot MD, PhD ,&nbsp;David A. Provenzano MD ,&nbsp;David M. Dickerson MD ,&nbsp;Sanket Dhruva MD ,&nbsp;Christopher Miranda Loftus MD, Dr.h.c. (Hon.) ,&nbsp;Nina Meizu-Nwaba PharmD, MPH, MSc ,&nbsp;David Prescott McMullen MD ,&nbsp;Richard B. North MD ,&nbsp;Pierre D’Haese PhD ,&nbsp;Peter E. Konrad MD, PhD ,&nbsp;Lawrence Poree MD, MPH, PhD","doi":"10.1016/j.neurom.2024.11.008","DOIUrl":"10.1016/j.neurom.2024.11.008","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Pages 700-702"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008845","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":"Response to: YouTube as a Source of Medical Information About Peripheral Nerve Stimulation","authors":"Levent Karataş MD","doi":"10.1016/j.neurom.2025.01.014","DOIUrl":"10.1016/j.neurom.2025.01.014","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Pages 703-704"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493062","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":"Noninvasive Vagus Nerve Stimulation in Parkinson’s Disease: A Systematic Review","authors":"Negin Eissazade MD ,&nbsp;Shayan Eghdami MD, MPH ,&nbsp;Mohammad Rohani MD ,&nbsp;Atra Ajdari MD ,&nbsp;Seyed-Mohammad Fereshtehnejad MD, PhD ,&nbsp;Alfonso Fasano MD ,&nbsp;Tara Khoeini MD","doi":"10.1016/j.neurom.2025.01.012","DOIUrl":"10.1016/j.neurom.2025.01.012","url":null,"abstract":"<div><h3>Background</h3><div>While pharmacologic interventions remain the mainstay of Parkinson’s disease (PD) treatment, alternative approaches such as vagus nerve stimulation (VNS) have drawn attention for their potential in managing PD symptoms.</div></div><div><h3>Objective</h3><div>We aimed to conduct a systematic review to comprehensively evaluate the safety and efficacy of VNS for motor and nonmotor symptoms of PD.</div></div><div><h3>Materials and Methods</h3><div>A systematic search was conducted across PubMed, Scopus, Cochrane Library, and Web of Science for relevant journal articles published up to October 2024. The findings were descriptively reported to evaluate the overall safety and efficacy of VNS in addressing both motor and nonmotor features of PD.</div></div><div><h3>Results</h3><div>A total of 12 journal articles with data from 287 participants were included. Ten studies reported that VNS significantly improved gait characteristics. Category fluency significantly declined in one study. Additionally, nonsignificant changes were observed in gastroenteric symptoms, fatigue, and both sympathetic and parasympathetic cardiac activity, with each of these outcomes reported in a separate study.</div></div><div><h3>Conclusions</h3><div>Noninvasive VNS demonstrated favorable safety and efficacy for gait impairments in patients with PD, indicating its potential as a versatile intervention capable of addressing multiple aspects of the disease pathology. However, further research is necessary to reveal the underlying mechanisms, optimize stimulation parameters, and assess the long-term safety and efficacy of VNS as a therapeutic strategy for PD.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Pages 641-651"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586419","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":"Poor Effectiveness of Occipital Nerve Stimulation in Treating Refractory Neuropathic Facial Pain: A Case Series","authors":"Sofia Ferrão Malheiro MD ,&nbsp;Nathan Beucler MD ,&nbsp;Aurélie Leplus MD ,&nbsp;Michel Lanteri-Minet MD ,&nbsp;Denys Fontaine MD, PhD","doi":"10.1016/j.neurom.2025.04.002","DOIUrl":"10.1016/j.neurom.2025.04.002","url":null,"abstract":"<div><h3>Context</h3><div>Neuropathic facial pain (NFP) that remains refractory to optimal pharmacologic management imposes a significant burden on patients and a challenge to pain specialists. Recent clinical evidence indicates that peripheral nerve stimulation (PNS) exhibits therapeutic potential in managing occipital and facial neuropathic pain. This study aims to evaluate the effectiveness of occipital nerve stimulation (ONS) specifically in the treatment of NFP.</div></div><div><h3>Materials and Methods</h3><div>We conducted a retrospective case series involving prospectively enrolled patients with refractory NFP unresponsive to optimal specific medical therapy and in some instances motor cortex stimulation. These patients were treated under a compassionate use framework for unilateral NFP using ONS. Each patient underwent an initial ONS trial lasting a minimum of two weeks. If they experienced an alleviation of their NFP &gt;40%, they proceeded to definitive implantation one month later.</div></div><div><h3>Results</h3><div>Overall, 13 patients were included in the study, with a mean age of 66 years and a male-to-female ratio of 1.2:1. The average duration from NFP onset to ONS surgery was 9.6 years. During the trial period, only six patients (46%) experienced significant improvement and proceeded to implantation. However, three of these patients (23%) did not report any benefit one month after implantation, motivating hardware removal. In addition, in two patients (15%), the initial improvement did not translate to long-term relief. Ultimately, only one patient (8%) reported sustained long-term improvement in NFP. Notably, this patient had experienced a ten-year benefit from motor cortex stimulation before they underwent ONS.</div></div><div><h3>Conclusion</h3><div>In light of our results, the limited and inconsistent improvements observed in a minority of patients suggest that ONS may not be a reliable surgical treatment option for NFP.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Pages 575-579"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026231","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":"2025 Calendar of Events - May","authors":"","doi":"10.1016/S1094-7159(25)00164-3","DOIUrl":"10.1016/S1094-7159(25)00164-3","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Page 709"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195488","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 Clinical Care Pathway for Patients With Chronic Mechanical Low Back Pain Having Restorative Neurostimulation for Multifidus Muscle: Description, Patient Compliance, Clinical Outcomes, and Satisfaction in the First Two Years","authors":"Allen J. Huang MBBS ,&nbsp;Derek Yull MBBS, BSc ,&nbsp;Yun-Hom Yau MBChB ,&nbsp;Mike Selby MBBS ,&nbsp;Kyle Craig BA Sci (Ex), MClinExPhys ,&nbsp;Tim Bass B Physio, M Physio (SportsPhysio) ,&nbsp;Sally Fish DipCouns ,&nbsp;Peter Murphy MBA, BEng, Innovation Management (Associate) ,&nbsp;Eleanor Clausen BSc, RGN, Dip Prof Studies, ENB 148 Neuroscience Nursing, Dip Change Management, Dip COPD ,&nbsp;Ian R. Whittle MBBS, MD (Adel), PhD","doi":"10.1016/j.neurom.2024.12.004","DOIUrl":"10.1016/j.neurom.2024.12.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Restorative neurostimulation for multifidus muscle is a novel therapy for chronic low back pain (CLBP). Optimal outcomes require interdisciplinary follow-up. We describe a clinical care pathway (CPW) for this therapy and report patient compliance, clinical outcomes, and patient satisfaction with the CPW.</div></div><div><h3>Materials and Methods</h3><div>This study aimed to develop, at a single center, a CPW with derivation, practical basis, description, and evolution. Included in the study were audits of 1) patient compliance with attendance over 24 months, 2) medical and paramedical attendance at the clinic, 3) clinical outcomes in terms of reductions in both patient and cohort disability (Oswestry Disability Index, ODI) and CLBP numeric rating score (NRS), and 4) adverse events; and a prospective cross-sectional survey of patient satisfaction with the CPW.</div></div><div><h3>Results</h3><div>A CPW that involved both preoperative and postoperative education and integrated interdisciplinary care was developed and incorporated into the clinical service with a dedicated clinic. In the two years under study, 172 patients attended the education session, and 92 proceeded to restorative neurostimulation for multifidus muscle therapy; 15 patients who had this therapy before the CPW also were incorporated into the CPW. Patient compliance with the pathway was 88% (95% CI 79%–94%) at 12 months. Attendance at the dedicated CPW clinic by the various subspeciality clinicians ranged between 74% and 100%. There were serial reductions in both ODI (38.9 [95% CI 35.9–41.9] to 24.7 (95% CI 21.1–28.3) and CLBP NRS (6.3 [95% CI 6.0–6.7] to 3.3 (95% 2.7–3.9) after 12 months; 76 of the 99 patients assessable (77%: 95% CI 67%–85%) had a minimally important clinical difference reduction in either ODI or pain NRS, whereas eight were unassessable. Patient satisfaction with the CPW was very high (mean 26.9; median 27, maximum 28).</div></div><div><h3>Conclusions</h3><div>The CPW facilitated clinical management and optimized outcomes in patients having restorative neurostimulation. Its design and delivery were very well accepted by patients.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Pages 558-566"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008839","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":"Incidence of Lead Tip Fracture and Retention After Percutaneous Lead Implantation for Peripheral Nerve Stimulation With an External Pulse Generator: A Multicenter Comparative Analysis of 456 Lead Implants Across Two Lead Hardware Generations","authors":"Chelsey Hoffmann PA-C, MS, RD ,&nbsp;Kalli J. Fautsch MD ,&nbsp;Ryan S. D’Souza MD","doi":"10.1016/j.neurom.2025.01.009","DOIUrl":"10.1016/j.neurom.2025.01.009","url":null,"abstract":"<div><h3>Objectives</h3><div>Lead fracture and retention are potential adverse events that can occur after peripheral nerve stimulator (PNS) lead implantation, although recent technologic advancements in PNS hardware have been implemented to avert this risk. We aim to quantify the current incidence of temporary PNS lead fracture/retention and compare this with rates before changes in lead hardware design of temporary PNS.</div></div><div><h3>Materials and Methods</h3><div>A multicenter, retrospective observational study was conducted for patients implanted with a temporary PNS system (SPR© Therapeutics, Cleveland, OH) between June 1, 2018 and August 1, 2024. Patients were included if they underwent a temporary percutaneous PNS system implantation with planned lead removal at 60 days. Patients were excluded if there was ambiguity regarding the status of the lead tip at time of removal (intact vs fractured) or if there was inadvertent lead removal by the patient during the 60-day treatment. The primary objectives of this study were 1) to quantify the incidence of lead retention with removal of temporary percutaneous PNS and 2) to compare the rates of lead retention in the original lead design (version 1.0) and the revised lead design (version 2.0). Secondary objectives included analysis of lead retention rates based on the following covariates: body mass index (BMI), patient age, location of lead placement, or duration of lead implant.</div></div><div><h3>Results</h3><div>Within the studied timeframe, 337 patients were implanted with a total of 456 leads. Of 337 patients, 40.4% (<em>n</em> = 136) were implanted with lead version 1.0, and 59.6% (<em>n</em> = 201) were implanted with lead version 2.0. Overall, 7.5% of implanted leads (34/456) were retained, affecting 10.1% of patients. Of 194 implanted version 1.0 leads, 13.4% of leads (<em>n</em> = 26) were retained, whereas of 262 version 2.0 leads, 3.1% (<em>n</em> = 8) were retained (<em>p</em> &lt; 0.001). These results showed a reduction in retained leads per patient from 19.1% with lead version 1.0 to 4.0% with revised lead version 2.0. Covariates including BMI, patient age, location of lead placement, or duration of lead implant did not predict lead retention rates.</div></div><div><h3>Conclusions</h3><div>Retention and fracture of temporary PNS leads remain prevalent, affecting 7.5% of all implanted leads, although we also observed a significant decrease in rates (3.1% vs 13.4%) with implementation of the revised lead version 2.0 hardware design.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Pages 611-618"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425675","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":"4. A survey of implantable neuromodulation for pain services across Canada","authors":"N. Prasad,&nbsp;J. Osborn,&nbsp;V. Varshney,&nbsp;A. Alomari,&nbsp;L. Weise,&nbsp;D. Alvares,&nbsp;V. Bains,&nbsp;A. Bhatia","doi":"10.1016/j.neurom.2025.03.006","DOIUrl":"10.1016/j.neurom.2025.03.006","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Page S3"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189726","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":"5. A two-centre retrospective review of spinal cord stimulator implantation with and without a screening trial","authors":"K. Marciniuk ,&nbsp;S. Girgis ,&nbsp;J. Buwembo ,&nbsp;A. Vitali ,&nbsp;J. Norton","doi":"10.1016/j.neurom.2025.03.007","DOIUrl":"10.1016/j.neurom.2025.03.007","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 4","pages":"Page S3"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189727","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}