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Peripheral Nerve Stimulation (peripheral + nerve_stimulation)

Distribution by Scientific Domains

Medical Sciences	90%

Distribution within Medical Sciences

Neurology	70%
Radiology & Imaging	30%

Selected Abstracts

Peripheral Nerve Stimulation or Is It Peripheral Subcutaneous Field Stimulation; What Is in a Moniker?

NEUROMODULATION, Issue 1 2009
David Abejón MD, FIPP
[source]

Peripheral Nerve Stimulation: A Treatment for Chronic Low Back Pain and Failed Back Surgery Syndrome?

NEUROMODULATION, Issue 1 2009
Paul Verrills MD
ABSTRACT Objective., This study aims to evaluate the usefulness of peripheral nerve stimulation as a treatment option for patients with chronic low back pain. Materials and Methods., More than 12 months, we collected data on consecutive patients who had successful trials and were subsequently implanted with octrode percutaneous leads placed subcutaneously within the major area of pain. Eleven patients met diagnostic criteria for failed back surgery syndrome. A questionnaire assessed outcomes including: pain, analgesic use, and patient satisfaction. The response rate was 93% (13/14): average follow-up time was seven months. Results., There was a significant decrease in pain levels: an average reduction of 3.77 visual analog scale points. Eleven patients (85%) reported successful outcomes and an average pain reduction of 4.18 points but two reported a poor response. Pain relief was highly correlated with reduced analgesia and patient satisfaction. No complications were reported. Conclusion., This study demonstrates a treatment option that is safe, nonpharmacologic, reversible, and effective for patients with chronic low back pain that have exhausted other treatment options. [source]

Peripheral Nerve Stimulation in Treatment of Intractable Postherpetic Neuralgia

NEUROMODULATION, Issue 4 2007
Alexander E. Yakovlev MD
ABSTRACT Objective., This case report presents an application of peripheral nerve stimulation to a patient with intractable postherpetic neuralgia that conventional treatment failed to ameliorate. Methods., The patient underwent an uneventful peripheral nerve stimulator trial with placement of two temporal eight-electrode percutaneous leads (Octrode leads, Advanced Neuromodulation Systems, Plano, TX, USA) into the right subscapular and right paraspinal area of the upper thoracic region. Results., Upon experiencing excellent pain relief over the next two weeks, the patient underwent implantation of permanent leads two weeks later and reported sustained pain relief. Conclusion. Peripheral nerve stimulation offers an alternative treatment option for intractable pain associated with postherpetic neuralgia, especially for elderly patients where treatment options are limited due to existing comorbidities. Further studies are warranted. [source]

Peripheral Neurostimulation for the Treatment of Chronic, Disabling Transformed Migraine

HEADACHE, Issue 4 2003
Charles A. Popeney DO
Background.,Up to 5% of the general population suffers from transformed migraine. This study analyzes clinical responses of transformed migraine to cervical peripheral nerve stimulation. Methods.,Headache frequency, severity, and disability (Migraine Disability Assessment [MIDAS] scores) were independently measured in an uncontrolled consecutive case series of 25 patients with transformed migraine implanted with C1 through C3 peripheral nerve stimulation. All patients met International Headache Society (IHS) criteria for episodic migraine, as well as suggested criteria for transformed migraine, and had been refractory to conventional treatment for at least 6 months. Responses to C1 through C3 peripheral nerve stimulation were recorded. Results.,Prior to stimulation, all patients experienced severe disability (grade IV on the MIDAS) with 75.56 headache days (average severity, 9.32; average MIDAS score, 121) over a 3-month period. Following stimulation, 15 patients reported little or no disability (grade I), 1 reported mild disability (grade II), 4 reported moderate disability (grade III), and 5 continued with severe disability (grade IV), with 37.45 headache days (average severity, 5.72; average MIDAS score, 15). The average improvement in the MIDAS score was 88.7%, with all patients reporting their headaches well controlled after stimulation. Conclusions.,These results raise the possibility that C1 through C3 peripheral nerve stimulation can help improve transformed migraine symptoms and disability. A controlled study is required to confirm these results. [source]

Simple anatomical measurements do not correlate significantly to individual peripheral nerve stimulation thresholds as measured in MRI gradient coils

JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 6 2003
Blaine A. Chronik PhD
Abstract Purpose To examine peripheral nerve stimulation (PNS) thresholds for normal human subjects in magnetic resonance imaging (MRI) gradient coils, and determine if observed thresholds could be predicted based on gross physiologic measurements. Materials and Methods PNS thresholds for 21 healthy normal subjects were measured using a whole-body gradient coil. Subjects were exposed to a trapezoidal echo-planar imaging (EPI) gradient waveform and the total change in gradient strength (,G) required to cause PNS as a function of the duration of the gradient switching time (,) were measured. Correlation coefficients and corresponding P values were calculated for the PNS threshold measurements against simple physiologic measurements taken of the subjects, including weight, height, girth, and average body fat percentage, in order to determine if there were any easily observable dependencies. Results No convincing correlations between threshold parameters and gross physiologic measurements were observed. Conclusion These results suggest it is unlikely that a simple physiologic measurement of subject anatomy can be used to guide the operation of MRI scanners in a subject-specific manner in order to increase gradient system performance while avoiding PNS. J. Magn. Reson. Imaging 2003;17:716,721. © 2003 Wiley-Liss, Inc. [source]

Experimental determination of human peripheral nerve stimulation thresholds in a 3-axis planar gradient system

MAGNETIC RESONANCE IN MEDICINE, Issue 3 2009
Rebecca E. Feldman
Abstract In MRI, strong, rapidly switched gradient fields are desirable because they can be used to reduce imaging time, obtain images with better resolution, or improve image signal-to-noise ratios. Improvements in gradient strength can be made by either increasing the gradient amplifier strength or by enhancing gradient efficiency. Unfortunately, many MRI pulse sequences, in combination with high-performance amplifiers and existing gradient hardware, can cause peripheral nerve stimulation (PNS). This makes improvements in gradient amplifiers ineffective at increasing safely usable gradient strength. Customized gradient coils are one way to achieve significant improvements in gradient performance. One specific gradient configuration, a planar gradient system, promises improved gradient strength and switching time for cardiac imaging. The PNS thresholds for planar gradients were characterized through human stimulation experiments on all three gradient axes. The specialized gradient was shown to have significantly higher stimulation thresholds than traditional cylindrical designs (y-axis SRmin = 210 ± 18 mT/m/ms and ,Gmin = 133 ± 13 mT/m; x-axis SRmin = 222 ± 24 mT/m/ms and ,Gmin = 147 ± 17 mT/m; z-axis SRmin = 252 ± 26 mT/m/ms and ,Gmin = 218 ± 26 mT/m). This system could be operated at gradient strengths 2 to 3 times higher than cylindrical configurations without causing stimulation. Magn Reson Med, 2009. © 2009 Wiley-Liss, Inc. [source]

Consideration of magnetically-induced and conservative electric fields within a loaded gradient coil

MAGNETIC RESONANCE IN MEDICINE, Issue 6 2006
Weihua Mao
Abstract We present a method to calculate the electric (E)-fields within and surrounding a human body in a gradient coil, including E-fields induced by the changing magnetic fields and "conservative" E-fields originating with the scalar electrical potential in the coil windings. In agreement with previous numerical calculations, it is shown that magnetically-induced E-fields within the human body show no real concentration near the surface of the body, where nerve stimulation most often occurs. Both the magnetically-induced and conservative E-fields are shown to be considerably stronger just outside the human body than inside it, and under some circumstances the conservative E-fields just outside the body can be much larger than the magnetically-induced E-fields there. The order of gradient winding and the presence of conductive RF shield can greatly affect the conservative E-field distribution in these cases. Though the E-fields against the outer surface of the body are not commonly considered, understanding gradient E-fields may be important for reasons other than peripheral nerve stimulation (PNS), such as potential interaction with electrical equipment. Magn Reson Med, 2006. © 2006 Wiley-Liss, Inc. [source]

Peripheral Nerve Stimulation: A Treatment for Chronic Low Back Pain and Failed Back Surgery Syndrome?

Peripheral Nerve Stimulation in Treatment of Intractable Postherpetic Neuralgia

Human motor associative plasticity induced by paired bihemispheric stimulation

THE JOURNAL OF PHYSIOLOGY, Issue 19 2009
Satoko Koganemaru
Paired associative stimulation (PAS) is an effective non-invasive method to induce human motor plasticity by the repetitive pairing of peripheral nerve stimulation and transcranial magnetic stimulation (TMS) at the primary motor cortex (M1) with a specific time interval. Although the repetitive pairing of two types of afferent stimulation might be a biological basis of neural plasticity and memory, other types of paired stimulation of the human brain have rarely been studied. We hypothesized that the repetitive pairing of TMS and interhemispheric cortico-cortical projection or paired bihemispheric stimulation (PBS), in which the right and left M1 were serially stimulated with a time interval of 15 ms, would produce an associative long-term potentiation (LTP)-like effect. In this study, 23 right-handed healthy volunteers were subjected to a 0.1 Hz repetition of 180 pairings of bihemispheric TMS, and physiological and behavioural measures of the motor system were compared before, immediately after, 20 min after and 40 min after PBS intervention. The amplitude of the motor evoked potential (MEP) induced by the left M1 stimulation and its input,output function increased for up to ,20 min post-PBS. Fine finger movements were also facilitated by PBS. Spinal excitability measured by the H-reflex was insensitive to PBS, suggesting a cortical mechanism. The associative LTP-like effect induced by PBS was timing dependent, occurring only when the interstimulus interval was 5,25 ms. These findings demonstrate that using PBS in PAS can induce motor cortical plasticity, and this approach might be applicable to the rehabilitation of patients with motor disorders. [source]