Introduction Paying proper attention to all technical aspects of neurostimulation device implantation makes all the difference in the long-term patient outcome with these devices. If these are truly going to be less invasive therapies, then the experience of undergoing implantation…
Overview All neurostimulators require an energy source to generate the electric fields which modulate the nervous system. The choice of technologies to power neurostimulators has a greater impact on the device design than any other choice. The use of an…
Introduction Neurostimulators can be generally categorized as either external or fully implantable. The former has a longer history because external neurostimulators do not have the design and operational challenges of limited power sources, convenient size, hermeticity, and control interfaces among…
Introduction A neuromodulation system may consist of two or more components, including the implantable pulse generator (IPG) and a therapy lead which delivers stimulation to the underlying neural tissue. The leads direct energy from the pulse generator to the target…
Introduction Neuromodulation requires a means of affecting the function of neurons and/or axons. This can be achieved by physical means such as changing temperature or mechanical pressure. Manipulation of the chemical environment by changing pH, ionic concentration, or the release…
Introduction All of neuromodulation is dependent on the delivery of a waveform comprised of electromagnetic fields to nervous system tissues in the human body. We are setting aside for now the types of neuromodulation working within the realm of light,…
Introduction One of the less commonly discussed areas of neuromodulation, peripheral nerve stimulation (PNS) is nonetheless probably its fastest growing direction, at least in the field of pain treatment. The approach, which is still considered novel and experimental by many,…
Introduction Neuromodulation and specifically epidural spinal cord stimulation (SCS) represented a fundamental change in the thought process behind pain control given that primarily irreversible ablative procedures had been used historically. The benefits of SCS include being reversible and adjustable. Advances…
Introduction The notion that functional brain disorders can be treated by modulating the activity of subcortical brain regions is nearly a century old. Meyers is credited with performing the first transventricular lesions of the basal ganglia [ ], but it…
Chapter 2 Stimulation of the brain cortex has emerged as one of the most promising avenues for palliation of neurological and psychiatric conditions. Cortical stimulation (CS) can be administered either noninvasively (NICS) ( Box 2.1 ) or invasively (ICS) [ ,…