Neurostimulation Therapy

St. Jude Medical Announces New Approvals Of Five-Column Neurostimulation Lead To Manage Chronic Pain

http://www.medicalnewstoday.com/articles/210228.php

"St. Jude Medical, Inc. (NYSE:STJ), a global medical device company, announced European CE Mark approval and regulatory and reimbursement approval from the Australian Therapeutic Goods Administration (TGA) of its Penta(TM) surgical lead for neurostimulation therapy.

Highlighted at the 14th annual North American Neuromodulation Society meeting in Las Vegas today, this innovative, five-column surgical lead is the first of its kind, featuring the smallest electrodes on the market. Although the Penta lead is only 10.9 mm wide, it offers the broadest lateral electrode span of any neurostimulation paddle lead. This feature is made possible by a proprietary micro-texturing process that enables greater amounts of current to be delivered via the small electrodes. The result is a lead that can more specifically focus current over a greater lateral area of the spinal cord, which may provide better coverage for managing chronic pain..."

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"...Spinal cord stimulation therapy, or neurostimulation therapy, is used for managing chronic pain of the trunk and limbs and pain from back surgeries that have failed. A lead is a small insulated wire with multiple electrodes that is placed in the epidural space near the spine. Mild electrical pulses are carried from the neurostimulator to the lead's electrodes to interrupt or mask the transmission of pain signals to the brain. Electrodes on the lead can be programmed to meet each individual patient's needs. 

"Neurostimulation therapy is often an appropriate choice for patients who have complex pain patterns," said Dr. Ashwini Sharan, Associate Professor, Department of Neurosurgery and Department of Neurology at Jefferson Medical College and Thomas Jefferson University. "The five-column Penta lead provides the most comprehensive spinal cord coverage available, enabling us to specifically stimulate targeted areas in order to potentially better control the patient's pain." 

Chronic pain is a largely undertreated and misunderstood condition that affects millions of patients worldwide. The World Health Organization, in conjunction with the International Association for the Study of Pain (IASP), reports that as many as one in five people suffers from moderate to severe chronic pain. .."

Predicting Value of Pain and Analgesia: Nucleus Accumbens Response to Noxious Stimuli Changes in the Presence of Chronic Pain

Neuron, Volume 66, Issue 1, 149-160, 15 April 2010  | 
Marwan N. Baliki,Paul Y. Geha,Howard L. Fields,A. Vania Apkarian

• • Copyright © 2010 Elsevier Inc. All rights reserved.  |  10.1016/j.neuron.2010.03.002
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  • Highlights
  • NAc predicts the reward value for expected pain relief in healthy subjects
  • NAc predicts the salience or arousal for imminent pain
  • Pain relief causes distinct NAc activities in healthy versus chronic pain subjects
  Summary
• We compared brain activations in response to acute noxious thermal stimuli in controls and chronic back pain (CBP) patients. Pain perception and related cortical activation patterns were similar in the two groups. However, nucleus accumbens (NAc) activity differentiated the groups at a very high accuracy, exhibiting phasic and tonic responses with distinct properties. Positive phasic NAc activations at stimulus onset and offset tracked stimulus salience and, in normal subjects, predicted reward (pain relief) magnitude at stimulus offset. In CBP, NAc activity correlated with different cortical circuitry from that of normals and phasic activity at stimulus offset was negative in polarity, suggesting that the acute pain relieves the ongoing back pain. The relieving effect was confirmed in a separate psychophysical study in CBP. Therefore, in contrast to somatosensory pathways, which reflect sensory properties of acute noxious stimuli, NAc activity in humans encodes its predicted value and anticipates its analgesic potential on chronic pain.