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State of the Art in Neuromodulation or Spinal Cord Stimulation Therapy

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 20 November 2025 | Viewed by 800

Special Issue Editor


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Guest Editor
Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
Interests: interventional chronic pain; neurostimulation; continuous and pulsed radiofrequency; trigeminal neuralgia; pu-dendal nerve syndrome; chronic peripheral pain; chronic joint pain

Special Issue Information

Dear Colleagues,

This Special Issue presents a comprehensive review of recent developments in neuro-modulation/stimulation therapies, focusing on their long-term efficacy, outcome prediction, and new therapeutic targets.

This collection emphasizes the importance of exploring new stimulation paradigms and their potential for sustained efficacy. There is a growing interest in evaluating the effectiveness of novel technologies (such as FAST, closed-loop, DTM, HF, etc.) and understanding whether these approaches can maintain long-term effectiveness while reducing loss of efficacy, a significant challenge in the long-term outcomes of neurostimulation. On the other hand, there is an increasing interest in neuromodulation techniques, such as pulsed radiofrequency and peripheral nerve stimulation, addressing new targets and algorithms.

Outcome prediction remains another critical area of research, as identifying reliable predictors of neuromodulation success can greatly enhance patient selection and treatment planning.

Additionally, the interplay between neuromodulation and opioid use is another field of interest, highlighting how neuromodulation is a valuable tool in reducing opioid use and addressing the challenges of opioid-related complications.

Emerging therapeutic targets in neuromodulation offer promising avenues for expanding the application of neuromodulation to previously undertreated conditions.

We invite submissions that explore these topics and more, including the integration of neuromodulation with advanced technologies such as artificial intelligence, which can enhance precision and tailored treatment strategies.

In conclusion, this Special Issue aims to provide healthcare professionals with insights, cutting-edge innovations and practical guidance for improving patient outcomes in the field of neuromodulation.

Dr. Marco Mercieri
Guest Editor

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 submissions that pass pre-check are 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. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly 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 2600 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

  • neuromodulation
  • spinal cord stimulation
  • chronic pain management
  • stimulation waveforms
  • long-term efficacy
  • loss of efficacy
  • outcome prediction
  • opioid-sparing techniques
  • neurostimulation mechanisms
  • psychological predictors
  • therapeutic targets

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Published Papers (1 paper)

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Research

13 pages, 1344 KiB  
Article
Long-Term Outcomes of Sacral Neuromodulation for Refractory Interstitial Cystitis/Bladder Pain Syndrome: A Retrospective Cohort Study
by Martina Rekatsina, Matteo Luigi Giuseppe Leoni, Veerle Visser-Vandewalle, Marco Mercieri, Giustino Varrassi and Georgios Matis
J. Clin. Med. 2025, 14(11), 3647; https://doi.org/10.3390/jcm14113647 - 22 May 2025
Viewed by 433
Abstract
Background: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition characterized by persistent bladder-related pain and urinary symptoms, often refractory to conventional treatments. Sacral neuromodulation (SNM) has emerged as a promising therapeutic option for managing refractory IC/BPS. Methods: This retrospective study [...] Read more.
Background: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition characterized by persistent bladder-related pain and urinary symptoms, often refractory to conventional treatments. Sacral neuromodulation (SNM) has emerged as a promising therapeutic option for managing refractory IC/BPS. Methods: This retrospective study included 24 patients with IC/BPS treated with SNM between 2017 and 2022. Baseline and follow-up data were collected on pain, opioid use, urinary symptoms, and quality of life. Patients underwent a trial of tonic stimulation before permanent implantation. Continuous variables were reported as median (IQR) and categorical data as counts and percentages. Pre- and post-SNM differences were analyzed using the Wilcoxon rank-sum test. Kaplan–Meier analysis evaluated lead survival, and a Sankey diagram illustrated employment status transitions. Results: Patients had a median age of 54.5 years (IQR: 47–61), with 92% female. Subtypes included Type 1 IC/BPS (8.3%), Type 2 (45.8%), Type 3 (37.6%), and unknown type (8.3%). Median pain duration was 4.5 years (IQR: 3–7.3). SNM resulted in significant improvements in pain (NRS: baseline 8 [IQR: 8–9], last follow-up 3 [IQR: 2–4], p < 0.0001), opioid use (MME: baseline 20 [IQR: 10–40], last follow-up 0 [IQR: 0–10], p < 0.0001), urinary function (24-h voids: baseline 19 [IQR: 14.5–25.8], last follow-up 8 [IQR: 6–12], p < 0.0001), and quality of life (QOL) (EQ-5D-5L: baseline 0.50 [IQR: 0.36–0.56], last follow-up 0.83 [IQR: 0.76–0.89], p < 0.0001). Employment rates increased from 43.5% to 50%, and unemployment decreased from 8.7% to 4.2%. The median follow-up was 35 months (IQR: 28–53). Conclusions: SNM significantly improved pain, urinary symptoms, quality of life, and employment outcomes in patients with refractory IC/BPS. These findings highlight its efficacy as a minimally invasive and reversible option for managing this challenging condition. Full article
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