The Evolution of Neuromodulation in the Treatment of Chronic Pain: Forward-Looking Perspectives
| Autor: | Timothy R. Deer, Robert Levy, Michael A Fishman, Ajay Antony, Michael F Esposito |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Technology
medicine.medical_specialty Stimulation Patterns Closed-Loop Electric Stimulation Therapy Technology development Optogenetics Noninvasive 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation 030202 anesthesiology Humans Pain Management Medicine Review Articles Miniaturization business.industry Chronic pain The Renaissance General Medicine Burst stimulation medicine.disease Neuromodulation (medicine) Anesthesiology and Pain Medicine Forward looking Current technology Neurology (clinical) Chronic Pain business 030217 neurology & neurosurgery |
| Zdroj: | Pain Medicine: The Official Journal of the American Academy of Pain Medicine |
| ISSN: | 1526-4637 1526-2375 |
| DOI: | 10.1093/pm/pnz074 |
| Popis: | Background The field of neuromodulation is continually evolving, with the past decade showing significant advancement in the therapeutic efficacy of neuromodulation procedures. The continued evolution of neuromodulation technology brings with it the promise of addressing the needs of both patients and physicians, as current technology improves and clinical applications expand. Design This review highlights the current state of the art of neuromodulation for treating chronic pain, describes key areas of development including stimulation patterns and neural targets, expanding indications and applications, feedback-controlled systems, noninvasive approaches, and biomarkers for neuromodulation and technology miniaturization. Results and Conclusions The field of neuromodulation is undergoing a renaissance of technology development with potential for profoundly improving the care of chronic pain patients. New and emerging targets like the dorsal root ganglion, as well as high-frequency and patterned stimulation methodologies such as burst stimulation, are paving the way for better clinical outcomes. As we look forward to the future, neural sensing, novel target-specific stimulation patterns, and approaches combining neuromodulation therapies are likely to significantly impact how neuromodulation is used. Moreover, select biomarkers may influence and guide the use of neuromodulation and help objectively demonstrate efficacy and outcomes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|