The Efficacy of Spinal Cord Stimulators in the Reduction of Multiple Sclerosis Spasticity: A Narrative Systematic Review

Goodwin, Brandon; Mahmud, Riaz; TomThundyil, Saumya; Rivera-Colon, Gerardo; Murray, Victoria; O’Donnell, Kelly

doi:10.12786/bn.2023.16.e19

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…This is consistent with research suggesting that neurostimulation can influence immune function and possibly reduce inflammatory markers, which are critical factors in the wound healing process. 19 …”

Section: Discussionmentioning

confidence: 99%

A meta‐analysis on the impact of spinal cord stimulation on post‐operative wound healing in patients with multiple sclerosis

Cai,

Zheng,

Gan

2024

International Wound Journal

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Spinal cord stimulation (SCS) has emerged as a potential therapeutic tool for various chronic conditions, but its efficacy in post‐operative wound healing for multiple sclerosis (MS) patients has not been comprehensively understood. This meta‐analysis aimed to evaluate the impact of SCS on post‐operative wound healing and scar formation in MS patients. A systematic literature review identified seven studies for inclusion. We focused on wound healing as measured by the redness, edema, ecchymosis, discharge, approximation (REEDA) scale 1 week post‐operation and scar formation assessed by the Manchester Scar Scale (MSS) 3 months post‐operation. The results demonstrated a significant improvement in wound healing in the SCS group, with a standard mean difference (SMD) of −5.82 (95% confidence interval [CI]: [−7.56, −4.09], p < 0.01) on the REEDA scale. For scar formation, the SCS group showed a notable reduction in MSS scores, with an SMD of −10.06 (95% CI: [−14.53, −5.58], p < 0.01). These findings underscore the potential of SCS as an adjunct therapy in enhancing surgical recovery in MS patients, pointing towards its broader applications in post‐operative care.

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Section: Discussionmentioning

confidence: 99%

A meta‐analysis on the impact of spinal cord stimulation on post‐operative wound healing in patients with multiple sclerosis

Cai,

Zheng,

Gan

2024

International Wound Journal

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“…Deep brain stimulation (DBS) has been (310). Also, spinal cord stimulation (SCS) seems beneficial for MS-associated pain and bladder issues but its efficacy for spasticity is mixed (311,312). Bladder disorders seems to benefit from peripheral tibial nerve stimulation (277).…”

Section: Neuromodulation Therapiesmentioning

confidence: 99%

Managing multiple sclerosis in individuals aged 55 and above: a comprehensive review

Fernández,

Sörensen,

Comi

et al. 2024

Front. Immunol.

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Multiple Sclerosis (MS) management in individuals aged 55 and above presents unique challenges due to the complex interaction between aging, comorbidities, immunosenescence, and MS pathophysiology. This comprehensive review explores the evolving landscape of MS in older adults, including the increased incidence and prevalence of MS in this age group, the shift in disease phenotypes from relapsing-remitting to progressive forms, and the presence of multimorbidity and polypharmacy. We aim to provide an updated review of the available evidence of disease-modifying treatments (DMTs) in older patients, including the efficacy and safety of existing therapies, emerging treatments such as Bruton tyrosine kinase (BTKs) inhibitors and those targeting remyelination and neuroprotection, and the critical decisions surrounding the initiation, de-escalation, and discontinuation of DMTs. Non-pharmacologic approaches, including physical therapy, neuromodulation therapies, cognitive rehabilitation, and psychotherapy, are also examined for their role in holistic care. The importance of MS Care Units and advance care planning are explored as a cornerstone in providing patient-centric care, ensuring alignment with patient preferences in the disease trajectory. Finally, the review emphasizes the need for personalized management and continuous monitoring of MS patients, alongside advocating for inclusive study designs in clinical research to improve the management of this growing patient demographic.

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A Pragmatic Review on Spinal Cord Stimulation Therapy for Parkinson's Disease Gait Related Disorders: Gaps and Controversies

Hvingelby,

Carra,

Terkelsen

et al. 2024

Movement Disord Clin Pract

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BackgroundParkinson's Disease (PD) is a progressive neurological disorder that results in potentially debilitating mobility deficits. Recently, spinal cord stimulation (SCS) has been proposed as a novel therapy for PD gait disorders. The highest levels of evidence remain limited for SCS.ObjectivesIn this systematic review and narrative synthesis, the literature was searched using combinations of key phrases indicating spinal cord stimulation and PD.MethodsWe included pre‐clinical studies and all published clinical trials, case reports, conference abstracts as well as protocols for ongoing clinical trials. Additionally, we included trials of SCS applied to atypical parkinsonism.ResultsA total of 45 human studies and trials met the inclusion criteria. Based on the narrative synthesis, a number of knowledge gaps and future avenues of potential research were identified. This review demonstrated that evidence for SCS is currently not sufficient to recommend it as an evidence‐based therapy for PD related gait disorders. There remain challenges and significant barriers to widespread implementation, including issues regarding patient selection, effective outcome selection, stimulation location and mode, and in programming parameter optimization. Results of early randomized controlled trials are currently pending. SCS is prone to placebo, lessebo and nocebo as well as blinding effects which may impact interpretation of outcomes, particularly when studies are underpowered.ConclusionTherapies such as SCS may build on current evidence and be shown to improve specific gait features in PD. Early negative trials should be interpreted with caution, as more evidence will be required to develop effective methodologies in order to drive clinical outcomes.

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The Efficacy of Spinal Cord Stimulators in the Reduction of Multiple Sclerosis Spasticity: A Narrative Systematic Review

Cited by 3 publications

References 36 publications

A meta‐analysis on the impact of spinal cord stimulation on post‐operative wound healing in patients with multiple sclerosis

A meta‐analysis on the impact of spinal cord stimulation on post‐operative wound healing in patients with multiple sclerosis

Managing multiple sclerosis in individuals aged 55 and above: a comprehensive review

A Pragmatic Review on Spinal Cord Stimulation Therapy for Parkinson's Disease Gait Related Disorders: Gaps and Controversies

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