What is Neuromodulation?

WHAT is Neuromodulation?
Neuromodulation refers to the electrical stimulation of a peripheral nerve, the spinal cord, or the brain intended to alter the transmission of nerve impulses.  Depending on the specific area targeted, it can provide significant relief of chronic pain or urinary frequency / incontinence.

It can also confer major improvements in quality of life by addressing the symptoms of Parkinson’s disease, dystonia and other movement disorders by increasing mobility and range of motion.  In some cases it has enabled patients to regain the ability to walk after suffering debilitating injury to the brain or spinal cord or the onset of multiple sclerosis.

Neuromodulation encompasses several different interventions including Spinal Cord Stimulation (SCS), Sacral Nerve Stimulation (SNS), Deep Brain Stimulation (DBS), as well as Intrathecal Drug Delivery (IDD).

WHAT is Spinal Cord Stimulation (SCS)?
Spinal Cord Stimulation is most commonly indicated for pain therapy.  The procedure uses low voltage electrical impulses to manage chronic refractory, neuropathic pain.  SCS involves the implantation of a stimulator, an extension cable, and a thin wire with electrodes (leads).  The leads are optimally placed to manage the pain.  An electrical current from the stimulator induces a tingling sensation that alters pain perception.

WHAT is Sacral Nerve Stimulation (SNS)?
The Sacral Nerve Stimulation is indicated for management of urinary urge incontinence, urgency-frequency, urinary incontinence, and fecal incontinence.  The procedure involves implanting a small generator in the lower abdomen that is attached to a lead with electrodes on the end.  The lead is placed next to the sacral nerve and electrical pulses stimulate the sacral nerve, which in turn stimulates bladder and bowel function.  SNS is intended for patients who have not responded to behavioral, drug, and/or interventional therapy.

WHAT is Deep Brain Stimulation (DBS)?
Deep Brain Stimulation is indicated in patients with movement disorders that are no longer adequately controlled with drug therapy.  Some examples of these movement disorders include Parkinson’s disease, tremor, and dystonia.  The DBS system consists of a stimulator, an extension cable, and a lead.  The procedure involves the implantation of the lead into specific target sites of the brain as well as the implantation of the stimulator in the upper chest.

WHAT is Intrathecal Drug Delivery (IDD)?
This system delivers drugs directly into the spinal column of the central nervous system and is primarily used in Canada to treat refractory pain (Morphine) and spasticity (Baclophen).  Spasticity is a motor disorder characterized by tight or stiff muscles that may interfere with voluntary muscle movements.  When drugs are administered intrathecally, they are concentrated in the spinal fluid, the site of the drug action, at higher levels than those attainable via oral administration.  As a result, concentrations required are significantly less and side effects such as drowsiness or confusion appear to be minimized.