Neurostimulation for Therapy-Resistant Depression (TRD)

Vagus Nerve Stimulation (VNS) and Other Augmentation Strategies for Therapy-Resistant Depression (TRD): Review of the Evidence and Clinical Advice for Use  – Free full text /PMC5902793/ – Apr 2018

This mini-review provides a comprehensive overview of augmentation pharmacotherapy and neurostimulation-based treatment strategies, with a special focus on VNS in TRD, and provides practical clinical advice for how to select TRD patients for add-on neurostimulation treatment strategies.

In addition to electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS), vagus nerve stimulation (VNS) is one of the approved neurostimulation tools for treatment of major depression.

If it weren’t so hard to get insurance to pay for these treatments, I’d have tried them long ago. However, the treatments of rTMS have to be frequent (almost daily for a while) and don’t always last longer than weeks (or even days) and I’m not going to drive an hour to appointments every few days. 

Electrical Current to the Brain Treats Chronic Back Pain

Can Electrical Current to the Brain Treat Chronic Back Pain? – National Pain Report – Nov 2018

I’ve often thought of trying some kind of neurostimulation for my pain, but with EDS it moves around from day to day depending on which joint is misaligned or which muscle is in spasm. Still, in these times of opiophobia, any alternate method of treating pain that provides even slight relief might be worth pursuing.

Researchers have demonstrated that they can target one region in the brain with weak electrical current and significantly decrease symptoms associated with chronic low back pain.  

The electrical current enhances the naturally occurring brain rhythms in that area of the brain.

I have never heard of this: “enhancing naturally occurring brain rhythms” except in “scrambler therapy“, which is not the same thing as regular neurostimulation.

Injuries & Deaths from Spinal Cord Stimulators

Spinal Cord Stimulators | Pain Management Specialist in San Diego & La Jolla – 11/26/2018 — Nancy Sajben MD

Since opioids have become so restricted, all kinds of other, previously found lacking, pain management methods are enjoying an unearned revival as desperate patients search for some relief to make their lives bearable.

The Washington Post is behind a paywall, so I’m showing the excerpts from the article that Dr. Sajben posted:

Washington Post Reports Injuries & Deaths from Spinal Cord Stimulators – Excerpts below are from the November 25 report linked here  

Spinal Cord Stimulators: Pulling out more than putting in

Spinal cord stimulators: ~ 10% are good candidates. Pulling out more than putting in | Pain Management Specialist in San Diego & La Jolla – 10/15/2018 — Nancy Sajben MD

PainWeek 2018 has a series of conferences in different cities. This weekend 10/13-10/14, it was in San Diego teaching pain management. Thank those who funded this 2 day program for doctors and healthcare providers to bring us up to date in the field.

Anesthesiology pain specialist Michael Bottros, MD, Associate Chief of the Division of Pain Medicine, Washington University St. Louis, made a comment on spinal cord stimulators:

“They are pulling out more than they are putting in.
Only 10% are good candidates.”

Spinal Cord Stimulators – Shortcomings of Evidence | Pain Management Specialist in San Diego & La Jolla – 09/25/2018 — Nancy Sajben MD  

Spinal cord stimulation in treatment of chronic pain

Current status and future perspectives of spinal cord stimulation in treatment of chronic pain : PAIN – May 2017

Introduction and history of spinal cord stimulation for chronic pain

In 1959, the neurosurgeon Willem Noordenbos reported that a signal carried along large diameter fibers for “touch, pressure or vibration” may inhibit the signal carried by the thinner “pain” fibers.  

Radiofrequency Ablation for Chronic Hip Pain

Radiofrequency Ablation for Chronic Hip Pain: Reviewing the Evidence – March 27, 2018 – Tori Rodriguez, MA, LPC

Many people with osteoarthritis and other degenerative diseases, including posttraumatic pain and rheumatoid arthritis, suffer from chronic hip pain.

Although total hip arthroplasty (THA) is often performed in patients with advanced disease, the procedure is associated with:

• 5% to 15% failure rate,
• high cost, and
• increased morbidity, mortality, and
• persistent postoperative pain

Specially Timed Signals Ease Tinnitus Symptoms

Specially Timed Signals Ease Tinnitus Symptoms in First Test Aimed at the Condition’s Root Cause – Dec 2017 – Michigan Medicine – University of Michigan

This isn’t pain-related, but I know many of us suffer from tinnitus too. I also found it interesting because it shows the potential of various neurostimulation treatments that target brain activity.

Millions of Americans hear ringing in their ears — a condition called tinnitus — but a new study shows an experimental device could help quiet the phantom sounds by targeting unruly nerve activity in the brain.

In a new paper in Science Translational Medicine, a team from the University of Michigan reports the results of the first animal tests and clinical trial of the approach, including data from 20 human tinnitus patients. 

Electroceuticals: the Shocking Future of Brain Zapping

Electroceuticals: the Shocking Future of Brain Zapping: Could electrical currents replace Big Pharma? – Beenish Ahmed and Eric Elder – Mar 10 2015

It’s all in your head—those icky feelings, all that fog—and chemicals just aren’t that great at cutting through. That’s why scientists are experimenting with changing the brain game by tweaking its circuitry, rather than the chemical processes.

It might be a bit unnerving to us seasoned pill-poppers, but some believe that electrical currents could be the new wave in everything cerebral, from treating depression and addiction to enhancements that would enable those seeking that mental edge to learn new skills faster or remember more.

While pharmaceutical companies rake in nearly $90 billion a year from global sales of mental health meds, psychopharmacology research and development has slowed to a crawl.  

Electroceutical devices to treat illness & pain

Potential for ‘electroceutical’ devices to treat illness, alleviate pain – Medical News Today – May 2014

A Stanford electrical engineer has invented a way to wirelessly transfer power deep inside the body, and then use this power to run tiny electronic medical devices such as pacemakers, nerve stimulators, or new sensors and gadgets yet to be developed.

The discoveries reported in the Proceedings of the National Academy of Sciences (PNAS) culminate years of efforts by Ada Poon, an assistant professor of electrical engineering, to eliminate the bulky batteries and clumsy recharging systems that prevent medical devices from being more widely used.

“We need to make these devices as small as possible to more easily implant them deep in the body and create new ways to treat illness and alleviate pain,” said Poon.

This is what Silicon Valley is good for. Once the specifications are set, some company will build a miniature implantable device.  

The shock tactics set to shake up immunology

The shock tactics set to shake up immunology: Nature News & Comment – May 2017  – Douglas Fox

An experimental procedure is exposing the links between the nervous and immune systems. Could it be the start of a revolution?

Six times a day, Katrin pauses whatever she’s doing, removes a small magnet from her pocket and touches it to a raised patch of skin just below her collarbone. For 60 seconds, she feels a soft vibration in her throat. Her voice quavers if she talks. Then, the sensation subsides.

The magnet switches on an implanted device that emits a series of electrical pulses — each about a milliamp, similar to the current drawn by a typical hearing aid.