Special Issue "Neuromodulation for Intractable Pain"

A special issue of Brain Sciences (ISSN 2076-3425).

Deadline for manuscript submissions: closed (5 August 2018)

Special Issue Editors

Guest Editor
Prof. Dr. Tipu Aziz

Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
Website | E-Mail
Interests: Parkinson’s disease; movement disorders; pain; functional neurosurgery
Guest Editor
Dr. Alex Green

Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
Website | E-Mail
Interests: Parkinson’s disease; movement disorders; pain; functional neurosurgery

Special Issue Information

Dear Colleagues,

Over 7% of the Western population suffers from intractable pain. Despite pharmacotherapy, many patients (1.5%) suffer from refractory pain. In addition to the pain, patients continue to be highly debilitated and suffer from depression and anxiety, poor quality of life and loss of employment. An ever enlarging global problem concerns the use of opiates which have risen to dangerous levels. Neuromodulation of the nervous system—where the function of the nervous system is altered by a device—has, over time, emerged as an effective alternative to pharmacotherapy in the management of these patients.

In this Special Issue, we will discuss the indications, safety, efficacy, mechanisms of action and other aspects of neurmodulation therapies for pain relief. These include peripheral nerve stimulation, peripheral field stimulation, spinal cord stimulation, dorsal root ganglion stimulation, motor cortex stimulation and deep brain stimulation.

We do not intend this Special Issue to be a comprehensive study of pain but a guide to help clinicians to refer patients appropriately and to decide which procedure would best be offered in certain situations.

Prof. Dr. Tipu Aziz
Dr. Alex Green
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 650 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Neuropathic pain
  • Neuromodulation
  • Intractable pain
  • depression and anxiety
  • nervous system

Published Papers (3 papers)

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Review

Open AccessReview Neuromodulation for Pelvic and Urogenital Pain
Brain Sci. 2018, 8(10), 180; https://doi.org/10.3390/brainsci8100180
Received: 14 August 2018 / Revised: 27 September 2018 / Accepted: 28 September 2018 / Published: 29 September 2018
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Abstract
Chronic pain affecting the pelvic and urogenital area is a major clinical problem with heterogeneous etiology, affecting both male and female patients and severely compromising quality of life. In cases where pharmacotherapy is ineffective, neuromodulation is proving to be a potential avenue to
[...] Read more.
Chronic pain affecting the pelvic and urogenital area is a major clinical problem with heterogeneous etiology, affecting both male and female patients and severely compromising quality of life. In cases where pharmacotherapy is ineffective, neuromodulation is proving to be a potential avenue to enhance analgesic outcomes. However, clinicians who frequently see patients with pelvic pain are not traditionally trained in a range of neuromodulation techniques. The aim of this overview is to describe major types of pelvic and urogenital pain syndromes and the neuromodulation approaches that have been trialed, including peripheral nerve stimulation, dorsal root ganglion stimulation, spinal cord stimulation, and brain stimulation techniques. Our conclusion is that neuromodulation, particularly of the peripheral nerves, may provide benefits for patients with pelvic pain. However, larger prospective randomized studies with carefully selected patient groups are required to establish efficacy and determine which patients are likely to achieve the best outcomes. Full article
(This article belongs to the Special Issue Neuromodulation for Intractable Pain)
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Open AccessReview The Current State of Deep Brain Stimulation for Chronic Pain and Its Context in Other Forms of Neuromodulation
Brain Sci. 2018, 8(8), 158; https://doi.org/10.3390/brainsci8080158
Received: 17 July 2018 / Revised: 8 August 2018 / Accepted: 13 August 2018 / Published: 20 August 2018
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Abstract
Chronic intractable pain is debilitating for those touched, affecting 5% of the population. Deep brain stimulation (DBS) has fallen out of favour as the centrally implantable neurostimulation of choice for chronic pain since the 1970–1980s, with some neurosurgeons favouring motor cortex stimulation as
[...] Read more.
Chronic intractable pain is debilitating for those touched, affecting 5% of the population. Deep brain stimulation (DBS) has fallen out of favour as the centrally implantable neurostimulation of choice for chronic pain since the 1970–1980s, with some neurosurgeons favouring motor cortex stimulation as the ‘last chance saloon’. This article reviews the available data and professional opinion of the current state of DBS as a treatment for chronic pain, placing it in the context of other neuromodulation therapies. We suggest DBS, with its newer target, namely anterior cingulate cortex (ACC), should not be blacklisted on the basis of a lack of good quality study data, which often fails to capture the merits of the treatment. Full article
(This article belongs to the Special Issue Neuromodulation for Intractable Pain)
Open AccessReview Spinal Cord Stimulation for Neuropathic Pain: Current Trends and Future Applications
Brain Sci. 2018, 8(8), 138; https://doi.org/10.3390/brainsci8080138
Received: 30 June 2018 / Accepted: 18 July 2018 / Published: 24 July 2018
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Abstract
The origin and the neural pathways involved in chronic neuropathic pain are still not extensively understood. For this reason, despite the wide variety of pain medications available on the market, neuropathic pain is challenging to treat. The present therapeutic alternative considered as the
[...] Read more.
The origin and the neural pathways involved in chronic neuropathic pain are still not extensively understood. For this reason, despite the wide variety of pain medications available on the market, neuropathic pain is challenging to treat. The present therapeutic alternative considered as the gold standard for many kinds of chronic neuropathic pain is epidural spinal cord stimulation (SCS). Despite its proved efficacy, the favourable cost-effectiveness when compared to the long-term use of poorly effective drugs and the expanding array of indications and technical improvements, SCS is still worldwide largely neglected by general practitioners, neurologists, neurosurgeons and pain therapists, often bringing to a large delay in considering as a therapeutic option for patients affected by neuropathic chronic pain. The present state of the art of SCS in the treatment of chronic neuropathic pain is here overviewed and speculations on whether to use a trial period or direct implant, to choose between percutaneous leads or paddle electrodes and on the pros and cons of the different patterns of stimulation presently available on the market (tonic stim, high-frequency stim and burst stim) are described. Full article
(This article belongs to the Special Issue Neuromodulation for Intractable Pain)
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