Peripheral Nerve Stimulation of Brachial Plexus Nerve Roots and Supra-Scapular Nerve for Chronic Refractory Neuropathic Pain of the Upper Limb

Bouche, Bénédicte; Manfiotto, Marie; Rigoard, Philippe; Lemarié, J.; Dixneuf, Véronique; Lantéri-Minet, Michel; Fontaine, Denys

doi:10.1111/ner.12573

Cited by 35 publications

(20 citation statements)

References 28 publications

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“…There were no RCTs found that assessed the efficacy of PNS therapy to the suprascapular nerve in chronic refractory shoulder pain patients. Table 4 lists all four clinical reports obtained for stimulator implants on the suprascapular nerve [9][10][11][12]. Among the two case reports listed: one patient had no pain at rest and excellent shoulder joint range of motion at the 3-month follow-up [9], while the other had no pain and did not require any pain medications at 9 months post-implantation [11].…”

Section: Literature Reviewmentioning

confidence: 99%

“…There was also a large prospective case series which included one patient who underwent an implant on the suprascapular nerve and experienced 66.7% improvement in pain scores and 80% improvement in movement capacity [12]. Lastly, there was a retrospective case series in which a subset of nine patients underwent suprascapular nerve stimulator implant: pain score improved > 50% for eight patients, mean pain improvement was 70%, and 6 patients had > 50% improvement at last follow-up which was between 2 to 4 years [10].…”

Section: Literature Reviewmentioning

confidence: 99%

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Comparing neuromodulation modalities involving the suprascapular nerve in chronic refractory shoulder pain: retrospective case series and literature review

Dey

2021

Clin Shoulder Elbow

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Chronic shoulder pain not relieved by either conservative or surgical management is referred to as chronic refractory shoulder pain. This is a retrospective case series where chronic refractory shoulder pain patients were treated either with peripheral nerve stimulation (PNS) or with pulsed radiofrequency (p-RF) therapy to the suprascapular nerve. Both patients receiving PNS reported 100% pain relief for the first month. At the 3- and 6-month follow-ups, one patient continued to experience 100% relief while the other reported 90% relief. One patient undergoing p-RF experienced about 90% pain relief at both 1- and 3-month intervals and 0% relief at the 6-month interval. The other patient with p-RF experienced 33% relief at 1-month and 0% relief thereafter. No patient reported any complications. The results of previous randomized controlled trials evaluating the efficacy of p-RF administered to the suprascapular nerve were mixed, and there is a lack of published studies on PNS effects. Neuromodulation of the suprascapular nerve can be effective for chronic refractory shoulder pain patients. Larger scale randomized controlled trials comparing PNS and p-RF are needed to better understand their respective therapeutic capacity.

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Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Comparing neuromodulation modalities involving the suprascapular nerve in chronic refractory shoulder pain: retrospective case series and literature review

Dey

2021

Clin Shoulder Elbow

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“…Peripheral nerve stimulation provides 50-83% pain relief in 65-80% of the patients [116][117][118][119][120], and the affected limb preserves the residual function remaining after the injury [121]. Allodynia and neuropathic pain are controlled with mild improvement in the sensory function [116,118]. The results are stable long-term [118,119,121].…”

Section: Neuromodulation Proceduresmentioning

confidence: 99%

“…The results are stable long-term [118,119,121]. The electrodes can be implanted with an open surgical procedure [117,119] or percutaneously under ultrasound guidance [116,120]. Unfortunately lead fracture, displacement or infection can spoil an initial successful result [116,120].…”

Section: Neuromodulation Proceduresmentioning

confidence: 99%

“…The electrodes can be implanted with an open surgical procedure [117,119] or percutaneously under ultrasound guidance [116,120]. Unfortunately lead fracture, displacement or infection can spoil an initial successful result [116,120]. A further refinement is to apply the stimulating electrodes not through a cuff around the affected nerve but by direct selective nerve fascicle stimulation [122].…”

Section: Neuromodulation Proceduresmentioning

confidence: 99%

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Treatment of Neuropathic Pain in Brachial Plexus Injuries

Saiz-Sapena¹,

Vanaclocha‐Vanaclocha²,

Ortiz-Criado³

et al. 2019

Treatment of Brachial Plexus Injuries

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Brachial plexus injuries are commonly followed by chronic pain, mostly with neuropathic characteristics. This is due to peripheral nerve lesions, particularly nerve root avulsions, as well as upper limb amputations, and complex regional pain syndrome (CRPS). The differential diagnosis between CRPS and neuropathic pain is essential as the treatment is different for each of them. Medical treatments are the first step, but for refractory cases there are two main types of surgical alternatives: ablative techniques and neuromodulation. The first group involves destruction of the posterior horn deafferented neurons and usually provides a better pain control but has a 10% complication rate. The second group provides pain control with function preservation but with limited effectiveness. Each case has to be thoroughly evaluated to apply the treatment modality best suited for it. due to iatrogenia [8][9][10][11][12][13][14][15][16], particularly during lymph node biopsy [17, 18] or treatment of some malignancies [19]. The pain is chronic [20], persistent [7], constant [21], burning [22] and throbbing [17], with paroxysmal discharges [3, 6, 23], particularly upon gentle rubbing the affected area [4].The pain is distributed in the distal areas of the upper limb, covering several dermatomes, mostly the caudal ones [24] and particularly the hand [5, 17, 23, 25]. The paroxysmal pain is felt in the arm [26]. Allodynia, hypersensitivity and electric-like discharges are present at the border between the normal and affected dermatomes [17,[26][27][28][29], particularly between T 1 and T 2 at the posterior aspect of the elbow [26].The pain severity correlates with the magnitude of the brachial plexus injury [2,3] and to the number of avulsed nerve roots [2-4, 21, 26, 30-33], particularly when the lower roots are affected [24,34,35]. Nevertheless, Bertelli et al. [21] found that in isolated C 8 and T 1 nerve root avulsions, there was no pain at all.The pain does not appear immediately after the injury but a few days later [24] and no longer than 3 months after it [5, 6, 24, 26,35,36].The neuropathic pain can be associated with phantom [37] or stump pain [38] in case of upper limb amputation, or to complex regional pain syndrome (CRPS) [6], inducing a complex pain condition rather difficult to control [19,30,31].Self-mutilation has been described in 5-29% of obstetric brachial plexus injury cases [39,40].The quality of life is seriously impaired with sleep disorders, family troubles, unemployment, chronic depression and social withdrawal [2, 5, 6, 17, 21,[41][42][43][44]. Additionally, the chronic pain is a further hindrance to comply with a good rehabilitation programme, impairing a possible functional recovery [6,45,46]. Among all the disabilities induced by the brachial plexus injury, the pain has been found to be the symptom that most negatively affects the quality of life [47].Treatment of this chronic pain can be troublesome, as the response to the different treatment modalities is poor and not all of them allow preservatio...

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Design Parameters and Human Biocompatibility Assessment Protocols for Organic Semiconducting Neural Interfaces: Toward a Printed Artificial Retina with Color Vision

Sherwood

Crovador

Posar

et al. 2023

Adv Materials Inter

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Organic semiconductors have emerged as promising neural interfacing materials due to their innate biocompatibility, soft mechanical properties, and mixed electron/ion conduction. One exciting application is their use as artificial photosensors for retinal prostheses via optically induced neuromodulation. In this study, the optoelectronic and neural interfacing properties of six organic semiconductor polymers and small molecules, split into donor/acceptor pairs that form promising candidates for a trichromatic artificial retina that closely mimics the native response of the human eye are presented. The biocompatibility of these materials using primary human retinal cell cultures by systematic measurement of both cell viability and morphological analysis of retinal ganglion cell neurite elongation over time is investigated. Comparable cell viability between human retinal cell cultures established on all the organic semiconductors and a glass control, which is a standard measurement for biocompatibility in materials science is observed. In contrast, differences in the morphological biocompatibility between the organic semiconductor materials and glass control are detected by analyzing neurite elongation with specific immunomarkers. The difference in the two results has implications for the future assessment of material biocompatibility for bioelectronics, and optimal methodology for assessing morphological biocompatibility in neural interface devices is discussed.

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Peripheral Nerve Stimulation of Brachial Plexus Nerve Roots and Supra-Scapular Nerve for Chronic Refractory Neuropathic Pain of the Upper Limb

Cited by 35 publications

References 28 publications

Comparing neuromodulation modalities involving the suprascapular nerve in chronic refractory shoulder pain: retrospective case series and literature review

Comparing neuromodulation modalities involving the suprascapular nerve in chronic refractory shoulder pain: retrospective case series and literature review

Treatment of Neuropathic Pain in Brachial Plexus Injuries

Design Parameters and Human Biocompatibility Assessment Protocols for Organic Semiconducting Neural Interfaces: Toward a Printed Artificial Retina with Color Vision

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