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

Autor: Sivanesan E; Department of Anesthesiology and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA. Electronic address: esivane1@jh.edu., North RB; Department of Anesthesiology and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA., Russo MA; Hunter Pain Specialists, Broadmeadow, New South Wales, Australia., Levy RM; Neurosurgical Services, Clinical Research, Anesthesia Pain Care Consultants, Tamarac, FL, USA., Linderoth B; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden., Hayek SM; Division of Pain Medicine, University Hospitals, Cleveland Medical Center, Cleveland, OH, USA., Eldabe S; Department of Pain Medicine, The James Cook University Hospital, Middlesbrough, UK., Lempka SF; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA; Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA.
Jazyk: angličtina
Zdroj: Neuromodulation : journal of the International Neuromodulation Society [Neuromodulation] 2024 Jan; Vol. 27 (1), pp. 1-12. Date of Electronic Publication: 2023 Nov 11.
DOI: 10.1016/j.neurom.2023.10.004
Abstrakt: Objectives: Neuromodulation 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.
Approach: We 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.
Results: We 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.
Conclusions: This 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.
Competing Interests: Conflict of Interest Richard B. North holds >30 patents in the field of neuromodulation and currently receives royalties from Abbott. Marc A. Russo reports research activities (paid to research institution) for Boston Scientific, Mainstay Medical, Medtronic, Nevro, Presidio Medical, and Saluda Medical, historical equity interest in Lungpacer and SPR Therapeutics, and stock options in Saluda Medical and Presidio Medical. Marc A. Russo is President of the International Neuromodulation Society and Director-at-Large of the Neuromodulation Society of Australia and New Zealand. Robert M. Levy is an uncompensated consultant for Biotronik, Abbott, Nalu, Saluda Medical, and Mainstay Medical and has stock options from Nalu and Saluda Medical obtained before 2019, not exercisable through the duration of his term as International Neuromodulation Society President and editor-in-chief of the journal Neuromodulation: Technology at the Neural Interface. Salim M. Hayek is the immediate past president of the North American Neuromodulation Society. Sam Eldabe consults for Mainstay Medical, Medtronic, and Saluda Medical. Sam Eldabe’s department research is funded by Boston Scientific, Saluda Medical, and Horizon Europe. Scott F. Lempka has equity in CereGate, Hologram Consultants, LLC, and Presidio Medical, Inc, is a member of the scientific advisory board, and receives consulting fees from Abbott Neuromodulation, CereGate, and Presidio Medical, Inc, and receives research support from Abbott Neuromodulation, Medtronic, plc, Neuromodulation Specialists, LTD, and Presidio Medical, Inc. All other authors reported no conflict of interest.
(Copyright © 2023 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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