Neuromodulation : journal of the International Neuromodulation Society
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Failed back surgery syndrome (FBSS) is a well-defined pathologic condition observed over many years. ⋯ The combination of SCS and PNfS, using the latest rechargeable systems, may be a valid therapeutic strategy in FBSS.
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Clinical Trial
Combined spinal cord and peripheral nerve field stimulation for persistent post-herniorrhaphy pain.
Chronic post-hernia pain is a common complication after inguinal herniorrhaphies. Peripheral nerve field stimulation (PNFS) and spinal cord stimulation (SCS) are two new promising treatment modalities. Four patients with persistent neuropathic post-hernia pain were recruited for this prospective study. ⋯ Both SCS and PNFS are effective in treating post-hernia pain, but the magnitude of pain reduction was more prominent with concomitant stimulation. Combined PNFS and SCS should be considered for patients with a less than optimal response to either SCS or PNFS. More studies are necessary to address the cost-effect issues of this new approach to treatment.
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The objective of our paper is to show the partial decrease of therapeutic effect with battery exhaustion in a previously successfully treated patient with refractory Tourette's syndrome (TS). ⋯ GPe seems to be a highly promising target of DBS for the treatment of medically refractory TS. After battery exhaustion, the patient experienced a marked partial decrease in the therapeutic effect, which confirms the beneficial action of this method.
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Responsive neurostimulation (RNS®) is an investigational treatment modality for intractable focal epilepsy. We analyzed impedance values over time to gain a better understanding of RNS device stability, potential differences between depth and strip electrodes, and general implications of long-term electrode implantation. ⋯ The RNS device provides unique long-term data for both depth and subdural electrodes in human subjects. Although changes in impedance were observed with respect to time after implantation and electrode type, these variations were of a clinically insignificant magnitude. As a constant-current system, the device is ultimately able to administer stable therapeutic doses in the setting such minor variability. While further animal research and post mortem investigations in human subjects are necessary to broaden our understanding of the mechanisms occurring at the electrode-neural interface and the biocompatibility of chronically implanted electrodes, the relative stability of impedances seen in this cohort of chronic implants brings promise to future implementations of chronic intracranial neural implants.
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Editorial Biography Historical Article
The shoulders of giants upon which we stand--the life and death of Dr. Yoshio Hosobuchi.