Neuromodulation : journal of the International Neuromodulation Society
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Comparative Study Clinical Trial
Selection of deep brain stimulation candidates in private neurology practices: referral may be simpler than a computerized triage system.
The objective of this study is to compare a computerized deep brain stimulation (DBS) screening module (Comparing Private Practice vs. Academic Centers in Selection of DBS Candidates [COMPRESS], NeuroTrax Corp., Bellaire, TX, USA) with traditional triage by a movement disorders specialized neurologist as the gold standard. ⋯ The COMPRESS agreed with an in-person evaluation by a movement disorders neurologist approximately 80% of the time. The computerized COMPRESS did not provide any screening advantage over the short FLASQ-PD paper questionnaire. Larger studies will be needed to assess the utility and cost effectiveness of this computerized triage method for DBS.
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Comparative Study
Sufentanil versus fentanyl: efficacy and patient satisfaction with intrathecal pain management.
This study compared fentanyl vs. sufentanil in intrathecal pain pumps. H1: both reduce patient subjective pain ratings. H2: sufentanil is more effective than fentanyl. H3: overall satisfaction with pain control is greater with sufentanil. ⋯ Sufentanil was found to be marginally more effective, but both medications controlled a significant degree of variance in pain reduction over time. A significantly greater number of patients maintained on sufentanil were satisfied with care than patients on fentanyl.
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Long-term studies of subthalamic nucleus (STN) deep brain stimulation (DBS) in patients with Parkinson's disease have shown potential cognitive and linguistic side-effects. In this pilot study, we examined whether direct monopolar stimulation in the ventral, associative STN would result in language effects. ⋯ Our data support previous findings implicating STN stimulation in cognitive-linguistic effects. A larger patient group with a blinded methodology is warranted.
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Patients with extensive surgery in the lumbar and thoracic spine are often not considered for neurostimulation due to the inability to perform a conventional spinal cord stimulation (SCS) trial. We are presenting six such patients in which spinal-peripheral neurostimulation (SPN) was used via a caudal approach. ⋯ SPN with a caudal lead appears to be a viable option for SCS trial in patients with no possibilities for conventional trial lead placement.
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With the advent of rechargeable internal neural stimulators (rINS) for deep brain stimulation, our aim was to survey patient satisfaction and clinical efficacy in an early cohort of patients receiving this new technology. ⋯ Most patients were happy with their rechargeable internal neural stimulator. A reduction in efficacy was noticed in 22% of patients, which is similar to the proportion of patients noticing a reduction in efficacy when replacing with a non-rechargeable system. Thus, all patients require close monitoring post-replacement of rINS, in case possible adjustment of parameters is required.