Neuromodulation and Pain

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neuroscience of Pain".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 7468

Special Issue Editor


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Guest Editor
Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, B6/319 CSC, Madison, WI 53792-3272, USA
Interests: pain; discogenic pain; knee degenerative disease
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Special Issue Information

Dear Colleagues,

Neuropathic pain (neuralgia) is one of the most common neuropathic symptoms. It refers to the pain felt in the absence of external stimulation, directly caused by the damage or disease of the somatosensory system. This disease can be caused by injury and/or disease to peripheral nerves, spinal cord posterior roots, spinal cord, and some parts of the central nervous system. It can be divided into peripheral neuralgia and central neuralgia.

Neuromodulation is an effective way to relieve pain. Neuromodulation by placing electrodes in the epidural space or cerebral cortex to stimulate the spinal cord or cerebral motor cortex has become widely used to treat intractable central and peripheral neuropathic pain, including medicine therapy, magnetic therapy, and electrotherapy.

We aim to discuss the most recent research related to neuromodulation for pain and solicit original research articles on the most recent, cutting-edge studies. We also welcome the submission of review articles and metanalyses.

Dr. Alaa Abd-Elsayed
Guest Editor

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Keywords

  • pain
  • neuropathic pain
  • stimulation
  • neuroimaging
  • electrotherapy
  • cannabidiol
  • spinal cord
  • neuromodulation
  • phantom limb pain

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Published Papers (4 papers)

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Editorial

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4 pages, 188 KiB  
Editorial
Spinal Cord Stimulation Efficacy and Erroneous Conclusions of the Cochrane Library Review of Spinal Cord Stimulation for Low Back Pain by Traeger et al.
by Michael Gyorfi, Ian Pillai and Alaa Abd-Elsayed
Brain Sci. 2023, 13(8), 1181; https://doi.org/10.3390/brainsci13081181 - 10 Aug 2023
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Abstract
Neuromodulation, through the use of spinal cord stimulation, is an evolving therapeutic alternative for the management of chronic and refractory pain [...] Full article
(This article belongs to the Special Issue Neuromodulation and Pain)

Research

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11 pages, 1445 KiB  
Article
Drug-Free Noninvasive Thermal Nerve Block: Validation of Sham Devices
by Michael A. Fishman, Ahish Chitneni, Alaa Abd-Elsayed, Samuel Grodofsky, Ashley M. Scherer, Brendan Schetzner, Malvina Klusek, Stephen R. Popielarski, Stephen Meloni, Steven Falowski, Philip Kim, Konstantin V. Slavin and Stephen D. Silberstein
Brain Sci. 2023, 13(12), 1718; https://doi.org/10.3390/brainsci13121718 - 15 Dec 2023
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Abstract
Headache is a leading cause of disability and suffering. One major challenge in developing device treatments is demonstrating their efficacy given devices’ often-high placebo rate. This paper reviews the importance of validating sham devices as part of finalizing the design for larger-scale prospective [...] Read more.
Headache is a leading cause of disability and suffering. One major challenge in developing device treatments is demonstrating their efficacy given devices’ often-high placebo rate. This paper reviews the importance of validating sham devices as part of finalizing the design for larger-scale prospective randomized controlled trials in patients with chronic headache as well as the results of a prospective, single-blind trial to validate two potential sham noninvasive thermal nerve block devices. Study participants were trained to self-administer thermal nerve block treatment using sham devices in an office visit. Two different sham systems with different temperature profiles were assessed. Devices were offered for patients to use daily at-home for one week to assess the durability of sham placebo effects before participants were given active treatment in a second office visit followed by another optional week of self-administered active treatment at-home use. Sham treatments reduced pain scores by an average of 31% from 6.0 ± 2.3 to 4.3 ± 3.3, including two participants who fell asleep during the in-office treatment and woke up with no pain, but whose pain recurred after returning home during at-home use of the sham system. In-office active treatments reduced pain scores by 52% from 6.7 ± 2.1 to 3.3 ± 2.9 with sustained pain relief during optional at-home use. Successful blinding for the study was confirmed with an ideal Bang’s Blinding Index of 0 and an ideal James’ Blinding Index of 1. Both the sham and active treatments were viewed by participants as highly credible, and credibility increased from the beginning to end of sham treatments on average. Full article
(This article belongs to the Special Issue Neuromodulation and Pain)
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Review

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22 pages, 2403 KiB  
Review
A Narrative Review of the Dorsal Root Ganglia and Spinal Cord Mechanisms of Action of Neuromodulation Therapies in Neuropathic Pain
by Matheus Deroco Veloso da Silva, Geovana Martelossi-Cebinelli, Kelly Megumi Yaekashi, Thacyana T. Carvalho, Sergio M. Borghi, Rubia Casagrande and Waldiceu A. Verri
Brain Sci. 2024, 14(6), 589; https://doi.org/10.3390/brainsci14060589 - 9 Jun 2024
Viewed by 2356
Abstract
Neuropathic pain arises from injuries to the nervous system in diseases such as diabetes, infections, toxicity, and traumas. The underlying mechanism of neuropathic pain involves peripheral and central pathological modifications. Peripheral mechanisms entail nerve damage, leading to neuronal hypersensitivity and ectopic action potentials. [...] Read more.
Neuropathic pain arises from injuries to the nervous system in diseases such as diabetes, infections, toxicity, and traumas. The underlying mechanism of neuropathic pain involves peripheral and central pathological modifications. Peripheral mechanisms entail nerve damage, leading to neuronal hypersensitivity and ectopic action potentials. Central sensitization involves a neuropathological process with increased responsiveness of the nociceptive neurons in the central nervous system (CNS) to their normal or subthreshold input due to persistent stimuli, leading to sustained electrical discharge, synaptic plasticity, and aberrant processing in the CNS. Current treatments, both pharmacological and non-pharmacological, aim to alleviate symptoms but often face challenges due to the complexity of neuropathic pain. Neuromodulation is emerging as an important therapeutic approach for the treatment of neuropathic pain in patients unresponsive to common therapies, by promoting the normalization of neuronal and/or glial activity and by targeting cerebral cortical regions, spinal cord, dorsal root ganglia, and nerve endings. Having a better understanding of the efficacy, adverse events and applicability of neuromodulation through pre-clinical studies is of great importance. Unveiling the mechanisms and characteristics of neuromodulation to manage neuropathic pain is essential to understand how to use it. In the present article, we review the current understanding supporting dorsal root ganglia and spinal cord neuromodulation as a therapeutic approach for neuropathic pain. Full article
(This article belongs to the Special Issue Neuromodulation and Pain)
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19 pages, 1440 KiB  
Review
Effects of Repetitive-Transcranial Magnetic Stimulation (rTMS) in Fibromyalgia Syndrome: An Umbrella and Mapping Review
by Ferran Cuenca-Martínez, Núria Sempere-Rubio, Sara Mollà-Casanova, Elena Muñoz-Gómez, Josué Fernández-Carnero, Alberto Sánchez-Sabater and Luis Suso-Martí
Brain Sci. 2023, 13(7), 1059; https://doi.org/10.3390/brainsci13071059 - 11 Jul 2023
Cited by 1 | Viewed by 1812
Abstract
Background: The main aim of this study was to assess the effects of repetitive-transcranial magnetic stimulation (rTMS) in patients with fibromyalgia (FMS). Methods: We systematically searched PubMed, PEDro, EMBASE, and CINAHL. Methodological quality was analyzed using the AMSTAR and ROBIS scales, and the [...] Read more.
Background: The main aim of this study was to assess the effects of repetitive-transcranial magnetic stimulation (rTMS) in patients with fibromyalgia (FMS). Methods: We systematically searched PubMed, PEDro, EMBASE, and CINAHL. Methodological quality was analyzed using the AMSTAR and ROBIS scales, and the strength of evidence was established according to the guidelines advisory committee grading criteria. A total of 11 systematic reviews were included. The assessed variables were pain intensity, depressive symptoms, anxiety, and general health. Results: Regarding pain intensity, it seems that high-frequency rTMS significantly reduces pain intensity at a 1-month follow-up when the primary motor cortex (M1) is stimulated. However, we cannot robustly conclude the same for low-frequency protocols. When we look at the combination of high and low-frequency rTMS, there seems to be a significant effect on pain intensity up to 1-week post-intervention, but after that point of follow-up, the results are controversial. Regarding depressive symptoms and anxiety, results showed that the effects of rTMS are almost non-existent. Finally, in regard to general health, results showed that rTMS caused significant post-intervention effects in a robust way. However, the results of the follow-ups are contradictory. Conclusions: The results obtained showed that high-frequency rTMS applied on the M1 showed some effect on the variable of pain intensity with a limited quality of evidence. Overall, rTMS was shown to be effective in improving general health with moderate quality of evidence. Finally, rTMS was not shown to be effective in managing depressive symptoms and anxiety with a limited to moderate quality of evidence. PROSPERO number: This review was previously registered in PROSPERO (CRD42023391032). Full article
(This article belongs to the Special Issue Neuromodulation and Pain)
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