Neuromodulation : journal of the International Neuromodulation Society
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Review Meta Analysis
Cervical Noninvasive Vagus Nerve Stimulation for Migraine and Cluster Headache: A Systematic Review and Meta-Analysis.
Noninvasive vagus nerve stimulation (nVNS) has been proposed as a new neuromodulation therapy to treat primary headache disorders. The purpose of this study was to analyze the effectiveness and safety of peripheral nerve stimulation of the cervical branch of the vagal nerve for primary headache disorders. ⋯ PROSPERO registration number CRD42019126009.
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Randomized Controlled Trial
Effects and Mechanisms of Transcutaneous Electrical Acustimulation on Postoperative Recovery After Elective Cesarean Section.
To explore the effects and mechanisms of transcutaneous electrical acustimulation (TEA) on postoperative recovery after cesarean section (CS). ⋯ Needleless non-invasive TEA at ST36 is effective in promoting both lower and upper GI symptoms after CS by enhancing vagal and suppressing sympathetic activities [Correction added on 23 June 2020, after first online publication: The first word of the preceded sentence has been corrected.].
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Case Reports
Paresthesia-Free Spinal Nerve Root Stimulation for the Treatment of Chronic Neuropathic Pain.
Stimulation of the dorsal spinal roots, or spinal nerve root stimulation (SNRS), is a neuromodulation modality that can target pain within specific dermatomal distributions. The use of paresthesia-free stimulation has been described with conventional dorsal column spinal cord stimulation, although has yet to be described for SNRS. This objective of this study was to investigate the efficacy of paresthesia-free high-frequency (1000-1200 Hz) SNRS in the treatment of intractable, dermatomal neuropathic pain. ⋯ We present real-world outcomes of patients with intractable dermatomal neuropathic pain treated with paresthesia-free, high-frequency SNRS. We demonstrate its effectiveness in providing pain reduction at a level comparable to tonic SNRS up to 24 months follow-up, without producing uncomfortable paresthesias.
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Case Reports
Axillary Peripheral Nerve Stimulation for Chronic Shoulder Pain: A Retrospective Case Series.
The objective of this study was to determine the effect of axillary peripheral nerve stimulation (PNS) on pain reduction in patients with chronic shoulder pain. Chronic shoulder pain was defined as pain greater than six months originating from any of the following and not the result of a stroke: subacromial impingement syndrome/rotator cuff pathology, glenohumeral joint arthritis, acromioclavicular joint arthritis, adhesive capsulitis, or biceps tendinopathy. ⋯ This retrospective case series provides level IV evidence supporting the use of axillary PNS therapy for the management of chronic shoulder pain. Additional, higher-level studies are required to further support its use.
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Objective real-world experience with peripheral nerve stimulation (PNS) is limited. Furthermore, the lack of robust outcome metrics, long-term follow-up and data comparing responders and nonresponders limit the refinement of selection criteria to better identify patients likely to benefit from PNS. ⋯ The present study adds to the PNS literature by providing long-term data and multiple outcome metrics in a subset of patients. We suggest that BDI, PCS, and MPQ may provide more insight into meaningful response over time. Evaluating functional and quality of life outcomes in patients with craniofacial pain may be more informative than assessing benefit solely based on pain intensity and responder rates.