TY - JOUR
T1 - Supraspinal Mechanisms of Spinal Cord Stimulation for Modulation of Pain
T2 - Five Decades of Research and Prospects for the Future
AU - Sivanesan, Eellan
AU - Maher, Dermot P.
AU - Raja, Srinivasa N.
AU - Linderoth, Bengt
AU - Guan, Yun
N1 - Funding Information:
This study was supported by the National Institutes of Health (Bethesda, Maryland) grant Nos. NS070814 and NS099879 (to Dr. Guan), and NS026363 (to Dr. Raja); by a grant from Neurosurgery Pain Research Institute at Johns Hopkins University (Baltimore, Maryland; to Dr. Guan); and by a Stimulating and Advancing Anesthesiology and Critical Care Medicine Research seed grant (to Dr. Sivanesan) from the Department of Anesthesiology and Critical Care Medicine at Johns Hopkins University.
Funding Information:
Drs. Guan and Raja received research grant support from Medtronic, Inc. (Minneapolis, Minnesota). Dr. Linderoth is a consultant for Medtronic, Inc., St. Jude Medical (Austin, Texas), Boston Scientific (Marlborough, Massachusetts), and Elekta AB (Sweden).The other authors declare no competing interests.
Publisher Copyright:
© 2019, the American Society of Anesthesiologists, Inc. Wolters Kluwer Health, Inc. All Rights Reserved.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - The field of spinal cord stimulation is expanding rapidly, with new waveform paradigms asserting supraspinal sites of action. The scope of treatment applications is also broadening from chronic pain to include cerebral ischemia, dystonia, tremor, multiple sclerosis, Parkinson disease, neuropsychiatric disorders, memory, addiction, cognitive function, and other neurologic diseases. The role of neurostimulation as an alternative strategy to opioids for chronic pain treatment is under robust discussion in both scientific and public forums. An understanding of the supraspinal mechanisms underlying the beneficial effects of spinal cord stimulation will aid in the appropriate application and development of optimal stimulation strategies for modulating pain signaling pathways. In this review, the authors focus on clinical and preclinical studies that indicate the role of supraspinal mechanisms in spinal cord stimulation-induced pain inhibition, and explore directions for future investigations.
AB - The field of spinal cord stimulation is expanding rapidly, with new waveform paradigms asserting supraspinal sites of action. The scope of treatment applications is also broadening from chronic pain to include cerebral ischemia, dystonia, tremor, multiple sclerosis, Parkinson disease, neuropsychiatric disorders, memory, addiction, cognitive function, and other neurologic diseases. The role of neurostimulation as an alternative strategy to opioids for chronic pain treatment is under robust discussion in both scientific and public forums. An understanding of the supraspinal mechanisms underlying the beneficial effects of spinal cord stimulation will aid in the appropriate application and development of optimal stimulation strategies for modulating pain signaling pathways. In this review, the authors focus on clinical and preclinical studies that indicate the role of supraspinal mechanisms in spinal cord stimulation-induced pain inhibition, and explore directions for future investigations.
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U2 - 10.1097/ALN.0000000000002353
DO - 10.1097/ALN.0000000000002353
M3 - Review article
C2 - 30556812
AN - SCOPUS:85062945971
SN - 0003-3022
VL - 130
SP - 651
EP - 665
JO - Anesthesiology
JF - Anesthesiology
IS - 4
ER -