The Appropriate Use of Neurostimulation: Stimulation of the Intracranial and Extracranial Space and Head for Chronic Pain. Issue 6 (August 2014)

• Record Type: Journal Article
• Authors: Deer, Timothy R.; Mekhail, Nagy; Petersen, Erika; Krames, Elliot; Staats, Peter; Pope, Jason; Saweris, Youssef; Lad, Shivanand P.; Diwan, Sudhir; Falowski, Steven; Feler, Claudio; Slavin, Konstantin; Narouze, Samer; Merabet, Lotfi; Buvanendran, Asokumar; Fregni, Felipe; Wellington, Joshua; Levy, Robert M.
• Is Part Of: Neuromodulaton. Volume 17:Issue 6(2014)
• Page Start: 551
• Page End: 570
• Publication Date: 2014-08
• Subjects: Central nervous system -- Physiology -- Periodicals; Central nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ner.12215
• Languages: English
• ISSNs: 1094-7159

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ner12215-sec-0001" sec-type="section"> <title>Introduction</title> <p>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.</p> </sec> <sec id="ner12215-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="ner12215-sec-0003" sec-type="section"> <title>Results</title> <p>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.</p> </sec> <sec id="ner12215-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>