Peripheral Nerve Stimulation for Neuropathic Pain

Slavin, Konstantin V.

doi:10.1016/j.nurt.2007.11.005

Cited by 185 publications

(103 citation statements)

References 68 publications

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“…Along with further elucidation of mechanisms underlying neural function, burgeoning interest in deep brain stimulation1, pain management2, functional electrical stimulation3, and brain-computer interfaces4 have created a demand for higher levels of neural specificity and control. Advances in electrical neural interface design have overcome many technical and biological challenges required to successfully excite and inhibit neural structures56.…”

mentioning

confidence: 99%

Transient and selective suppression of neural activity with infrared light

Duke

Jenkins

et al. 2013

Sci Rep

122

147

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Analysis and control of neural circuitry requires the ability to selectively activate or inhibit neurons. Previous work showed that infrared laser light selectively excited neural activity in endogenous unmyelinated and myelinated axons. However, inhibition of neuronal firing with infrared light was only observed in limited cases, is not well understood and was not precisely controlled. Using an experimentally tractable unmyelinated preparation for detailed investigation and a myelinated preparation for validation, we report that it is possible to selectively and transiently inhibit electrically-initiated axonal activation, as well as to both block or enhance the propagation of action potentials of specific motor neurons. Thus, in addition to previously shown excitation, we demonstrate an optical method of suppressing components of the nervous system with functional spatiotemporal precision. We believe this technique is well-suited for non-invasive investigations of diverse excitable tissues and may ultimately be applied for treating neurological disorders.

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mentioning

confidence: 99%

Transient and selective suppression of neural activity with infrared light

Duke

Jenkins

et al. 2013

Sci Rep

122

147

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“…It also requires permanent implantation of hardware, carrying the risk of surgical trauma and further tissue damage. Peripheral nerve stimulation has been also proposed to treat neuropathic pain [41], but more studies are necessary to confirm the role and efficacy of this treatment in chronic pain and the implantable hardware to perform peripheral nerve stimulation is still relatively nascent.…”

Section: Targeting Ion Channels In Drg Neurons and Their Axons Viamentioning

confidence: 99%

Targeting dorsal root ganglia and primary sensory neurons for the treatment of chronic pain

Berta

Qadri

Tan

et al. 2017

Expert Opinion on Therapeutic Targets

184

137

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Introduction Currently the treatment of chronic pain is inadequate and compromised by debilitating central nervous system side effects. Here we discuss new therapeutic strategies that target dorsal root ganglia (DRGs) in the peripheral nervous system for a better and safer treatment of chronic pain. Areas covered The DRGs contain the cell bodies of primary sensory neurons including nociceptive neurons. After painful injuries, primary sensory neurons demonstrate maladaptive molecular changes in DRG cell bodies and in their axons. These changes result in hypersensitivity and hyperexcitability of sensory neurons (peripheral sensitization) and are crucial for the onset and maintenance of chronic pain. We discuss the following new strategies to target DRGs and primary sensory neurons as a means of alleviating chronic pain and minimizing side effects: inhibition of sensory neuron-expressing ion channels such as TRPA1, TRPV1, and Nav1.7, selective blockade of C- and Aβ-afferent fibers, gene therapy, and implantation of bone marrow stem cells. Expert opinion These peripheral pharmacological treatments, as well as gene and cell therapies, aimed at DRG tissues and primary sensory neurons can offer better and safer treatments for inflammatory, neuropathic, cancer, and other chronic pain states.

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“…129−135 Following psychological evaluation and a short-term trial with temporary electrodes, the typical occipital nerve stimulator is implanted unilaterally or bilaterally, using a medial to lateral or lateral to medial approach, based on the preference of the surgeon. 136,137 Depending on the approach and the selected region of the targeted nerve, the electrode may directly contact the nerve or simply rest in the vicinity of the nerve. When vagus nerve stimulation systems are used, electrodes may be wrapped around the nerve 136 (cf.…”

Section: Occipital and Trigeminal Nerve Stimulationmentioning

confidence: 99%

“…Attached generators are implanted in an abdominal, gluteal, or infraclavicular pocket. 131,136 Occipital and trigeminal nerve stimulation strategies for pain have been largely successful, with efficacies of 70-100% based on reported reduction of frequency and intensity of pain or headaches and improvements in nociception. 130,138−140 It is believed that this high success rate is in large part due to appropriate patient selection following initial psychological and trial screening.…”

Section: Occipital and Trigeminal Nerve Stimulationmentioning

confidence: 99%

Bioinspired Design of Peripheral Nerve Devices

Shah¹

2014

Handbook of Biomimetics and Bioinspiration

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Devices of increasing functionality, complexity, and innovation have been designed to interface with the peripheral nervous system (PNS), to restore motor and sensory functional losses resulting from a wide range of neuromuscular disorders or injury. In this chapter, we review peripheral nerve anatomy, architecture, and concepts in nerve biomechanics. We then examine peripheral nerve devices currently in use clinically or under development, with an emphasis on physiological and biological interactions with each device. Based on the interplay between nerve architecture, biomechanics, and an implanted device, we suggest several criteria to be factored into design, evaluation, and implementation of the next generation of nerve devices. These include (i) appropriate scaling of a device to a targeted nerve to reduce compression or migration; (ii) lead stabilization or outright elimination; (iii) awareness of natural flexion, excursion, and strain of the targeted nerve prior to and following implantation; (iv) architectural characterization of the implantation site, both geometrically and biomechanically, accounting for subject-to-subject variability; (v) minimization of fibrosis; (vi) utilization of image-guided device implantation; and (vii) appropriate patient selection. Consideration of these criteria may help balance the continued improvement of device capabilities with an appropriate biomechanical and physiological response, towards enhanced neuromuscular and sensory function.

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Peripheral Nerve Stimulation for Neuropathic Pain

Cited by 185 publications

References 68 publications

Transient and selective suppression of neural activity with infrared light

Transient and selective suppression of neural activity with infrared light

Targeting dorsal root ganglia and primary sensory neurons for the treatment of chronic pain

Bioinspired Design of Peripheral Nerve Devices

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