• Neuromodulation · Jan 2024

    Review

    A Definition of Neuromodulation and Classification of Implantable Electrical Modulation for Chronic Pain.

    • Eellan Sivanesan, Richard B North, Marc A Russo, Robert M Levy, Bengt Linderoth, Salim M Hayek, Sam Eldabe, and Scott F Lempka.
    • Department of Anesthesiology and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA. Electronic address: esivane1@jh.edu.
    • Neuromodulation. 2024 Jan 1; 27 (1): 1121-12.

    ObjectivesNeuromodulation therapies use a variety of treatment modalities (eg, electrical stimulation) to treat chronic pain. These therapies have experienced rapid growth that has coincided with escalating confusion regarding the nomenclature surrounding these neuromodulation technologies. Furthermore, studies are often published without a complete description of the effective stimulation dose, making it impossible to replicate the findings. To improve clinical care and facilitate dissemination among the public, payors, research groups, and regulatory bodies, there is a clear need for a standardization of terms.ApproachWe formed an international group of authors comprising basic scientists, anesthesiologists, neurosurgeons, and engineers with expertise in neuromodulation. Because the field of neuromodulation is extensive, we chose to focus on creating a taxonomy and standardized definitions for implantable electrical modulation of chronic pain.ResultsWe first present a consensus definition of neuromodulation. We then describe a classification scheme based on the 1) intended use (the site of modulation and its indications) and 2) physical properties (waveforms and dose) of a neuromodulation therapy.ConclusionsThis framework will help guide future high-quality studies of implantable neuromodulatory treatments and improve reporting of their findings. Standardization with this classification scheme and clear definitions will help physicians, researchers, payors, and patients better understand the applications of implantable electrical modulation for pain and guide informed treatment decisions.Copyright © 2023 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.

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