TY - JOUR
T1 - The appropriate use of neurostimulation
T2 - Stimulation of the intracranial and extracranial space and head for chronic pain
AU - Deer, Timothy R.
AU - Mekhail, Nagy
AU - Petersen, Erika
AU - Krames, Elliot
AU - Staats, Peter
AU - Pope, Jason
AU - Saweris, Youssef
AU - Lad, Shivanand P.
AU - Diwan, Sudhir
AU - Falowski, Steven
AU - Feler, Claudio
AU - Slavin, Konstantin
AU - Narouze, Samer
AU - Merabet, Lotfi
AU - Buvanendran, Asokumar
AU - Fregni, Felipe
AU - Wellington, Joshua
AU - Levy, Robert M.
PY - 2014/8
Y1 - 2014/8
N2 - Introduction The International Neuromodulation Society (INS) has identified a need for evaluation and analysis of the practice of neurostimulation of the brain and extracranial nerves of the head to treat chronic pain. Methods The INS board of directors chose an expert panel, the Neuromodulation Appropriateness Consensus Committee (NACC), to evaluate the peer-reviewed literature, current research, and clinical experience and to give guidance for the appropriate use of these methods. The literature searches involved key word searches in PubMed, EMBASE, and Google Scholar dated 1970-2013, which were graded and evaluated by the authors. Results The NACC found that evidence supports extracranial stimulation for facial pain, migraine, and scalp pain but is limited for intracranial neuromodulation. High cervical spinal cord stimulation is an evolving option for facial pain. Intracranial neurostimulation may be an excellent option to treat diseases of the nervous system, such as tremor and Parkinson's disease, and in the future, potentially Alzheimer's disease and traumatic brain injury, but current use of intracranial stimulation for pain should be seen as investigational. Conclusions The NACC concludes that extracranial nerve stimulation should be considered in the algorithmic treatment of migraine and other disorders of the head. We should strive to perfect targets outside the cranium when treating pain, if at all possible.
AB - Introduction The International Neuromodulation Society (INS) has identified a need for evaluation and analysis of the practice of neurostimulation of the brain and extracranial nerves of the head to treat chronic pain. Methods The INS board of directors chose an expert panel, the Neuromodulation Appropriateness Consensus Committee (NACC), to evaluate the peer-reviewed literature, current research, and clinical experience and to give guidance for the appropriate use of these methods. The literature searches involved key word searches in PubMed, EMBASE, and Google Scholar dated 1970-2013, which were graded and evaluated by the authors. Results The NACC found that evidence supports extracranial stimulation for facial pain, migraine, and scalp pain but is limited for intracranial neuromodulation. High cervical spinal cord stimulation is an evolving option for facial pain. Intracranial neurostimulation may be an excellent option to treat diseases of the nervous system, such as tremor and Parkinson's disease, and in the future, potentially Alzheimer's disease and traumatic brain injury, but current use of intracranial stimulation for pain should be seen as investigational. Conclusions The NACC concludes that extracranial nerve stimulation should be considered in the algorithmic treatment of migraine and other disorders of the head. We should strive to perfect targets outside the cranium when treating pain, if at all possible.
KW - Cranial nerve stimulation
KW - deep brain stimulation
KW - migraine
KW - motor cortex stimulation
KW - neurostimulation
KW - occipital nerve stimulation
KW - peripheral nerve stimulation
KW - trigeminal nerve stimulation
KW - vagal nerve stimulation
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U2 - 10.1111/ner.12215
DO - 10.1111/ner.12215
M3 - Article
C2 - 25112890
AN - SCOPUS:84905962624
SN - 1094-7159
VL - 17
SP - 551
EP - 570
JO - Neuromodulation
JF - Neuromodulation
IS - 6
ER -