Abstract Highlights Precede June Neuromodulation Congress

The International Neuromodulation Society Accepts a Record Number of Scientific Abstracts at Its 11th World Congress

Newswise — BERLIN – The International Neuromodulation Society has accepted more than 300 scientific abstracts for its 11th World Congress, “Technology Transforming Chronic Illness Management.” From June 8 – 13, 2013, scientists and physicians will present the most comprehensive scope of current research in neuromodulation, a rapidly growing family of therapies that uses medical devices to relieve symptoms or restore function through alteration, or modulation, of nerve system function.

Research reported at the congress will address a wide range of conditions from movement disorders such as Parkinson’s disease to chronic neuropathic pain such as from spinal disease, trauma, diabetes or surgery; headache and facial pain syndromes; cardiovascular conditions such as chronic angina; epilepsy; pelvic organ motility disorders such as chronic constipation or fecal incontinence; gastrointestinal disorders such as gastric esophageal reflux disorder; rehabilitation from traumatic brain injury, stroke, or spinal cord injury; cancer pain; and psychiatric conditions such as post-traumatic stress disorder. Emerging brain therapies will also be a focus, including discussion about neuromodulation and optogenetics; persistent vegetative state and minimally conscious state; hypertension; and obesity.

Pre-conference seminars on June 8 and 9 focus on emerging science and the spread of access to therapies, with presentations from internationally renowned faculty, leading device companies and innovative startups.

Highlights about patient care and emerging technologies include:

Micro-Magnetic Stimulation (Monday, June 10) - John T. Gale, Ph.D., has demonstrated for the first time that deep brain stimulation with micro-magnets can activate brain cells in a living organism. Dr. Gale’s research team has shown that placing a micro-magnet on the auditory pathway of hamsters triggers nerve signal transmission. Stimulation from uniquely designed magnetic fields could avoid unintentional activation of nearby brain areas and the associated side effects. Micro-magnets might one day provide stimulation for heart pacing, cochlear implants, Parkinson's disease, or neural prosthetics.

Fibromyalgia (Monday, June 10 and Wednesday June 12) - Dr. Mark Plazier will report about a majority – 20 of 25 – of fibromyalgia patients finding significant relief of musculoskeletal pain after six months of investigational treatment with occipital nerve stimulation (ONS). PET scans of fibromyalgia patients with ONS points to a role for the limbic system – an area that gives meaning to the perception of pain. The same limbic pain system may be involved in migraine and cluster headache, which also have been shown to respond to ONS.

Migraine (Wednesday, June 12) Anna Andreou, Ph.D. will present results explaining how magnetic stimulation halts a spreading wave of over-excitation in brain cells, which is associated with migraine aura. Furthermore, results on how transcranial magnetic stimulation (TMS) interacts with thalamic pain centers relevant to both migraine with and without aura will be shown. Her preclinical studies help explain how using a handheld device to deliver transcranial magnetic stimulation to the back of the head resulted in a higher pain free rate than placebo (sham) stimulation in a randomized, controlled clinical trial. Moreover, the new data may help explain why, according to post-market analysis, single pulse TMS is equally effective in both migraine patients with and without aura.

Brain-Machine Interface (Wednesday, June 12) - Martin Schuettler, Ph.D. will talk about a prototype brain-machine interface for neurorehabilitation. The prototype was implanted on the surface of the brain of three sheep for nine months. Powered by an external inductive coupling device, it tracked changing stimulus, such as touch or brain stimulation, and relayed electrocorticogram recordings wirelessly through an infrared link. Clinical human trials are scheduled for 2014, and in the future, a miniaturized package might be implanted behind the ear to treat neurological conditions, or create an interface to direct neuroprosthetic devices by decoding various intentions, such as grasping.

High Blood Pressure (Monday, June 10) - Thomas Nielsen, Ph.D. will present work toward incorporating a continuous blood pressure monitor in a neuromodulation device to control hypertension. About one billion people suffer from hypertension and some 10 percent of these patients cannot control it with medication. Neuromodulation is an emerging therapy for treatment-resistant hypertension. Since vagus nerve transmissions help regulate blood pressure, a neurostimulator that senses those nerve transmissions may provide a way to indirectly monitor blood pressure, then respond with the appropriate level of stimulation. Preclinical work confirms that electrode readings from the vagus nerve, upon signal processing, correctly identify spikes in blood pressure.

Critical Care (Wednesday, June 12) - Roberto Cordella Ph.D. will describe a novel approach of using deep brain stimulation in acute neurological disease – or sudden worsening of pre-existing diseases – in emergency conditions. Eight patients in Italy received a deep brain stimulation (DBS) implant as an emergency procedure to treat severe, acute, life-threatening conditions of continuous involuntary movement (status dystonicus or post-stroke hemiballismus), or continuous epileptic seizures (status epilepticus). The patients were on deep sedation with tracheal intubation for mechanical ventilation prior to the DBS surgery, and conservative medications and sedation had not reversed their serious, life-threatening condition. Following the emergency DBS implant, the patients were weaned from the ventilator and discharged from intensive care a few weeks after surgery.

Disorders of Consciousness (Wednesday, June 12) - Dr. Stefanos Korfias will present results showing two patients steadily emerged from minimally conscious state after receiving intrathecal baclofen (ITB) after traumatic brain injury. The drug relaxes spasticity that can result from brain injury and may be used to facilitate care, but is not normally used to restore function. The patients, a 24-year-old man and a 29-year-old man, had been in minimally conscious states for three years and 18 months, respectively. Their scores on a revised coma recovery scale (with a maximum of 23) increased from 10 – 19 and 11 – 22, respectively.

Brain Activity Map (Wednesday, June 12) - Dr. Chengyuan Wu will discuss a novel tool for real time processing and mapping of brain activity that may help optimize electrode size and placement in patients with epilepsy undergoing surgical evaluation. Readings gathered in monitoring an epileptic patient were used to superimpose a brain-activity density map on an MRI image of the patient’s brain. He believes the capability could also help guide electrode location during implantation of deep brain stimulation or spinal cord stimulation systems. Treatment Effectiveness (Wednesday, June 12) - Dr. Krishna Kumar will present data demonstrating that initiating spinal cord stimulation (SCS) earlier rather than later contributes to greater effectiveness in the majority of patients. Already, SCS is the most common neuromodulation method. Despite increasing technical sophistication, in the year 2020, his analysis finds, spinal cord stimulation will continue to be cost-effective compared to optimum medical management.

Members of the news media interested in attending the conference or arranging telephone interviews with these and other speakers, please contact INS Public Education and Website Manager Nancy Garcia, [email protected]. Priority media registration for the congress ends May 15, 2013.

Images for use by news media and background information are available online at http://www.neuromodulation.com/newsroom#NR.

To view a preliminary congress program, please visit http://www.neuromodulation.com/ins-congress.

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About the International Neuromodulation Society (INS) The INS is a nonprofit group of clinicians, scientists and engineers dedicated to scientific development and knowledge of neuromodulation, a rapidly growing family of therapies developed to help relieve pain or restore function by delivering electromagnetic stimulation or chemical agents to specific sites in the body. Founded in 1989 and based in San Francisco, Calif., the INS has 15 current and four forming chapters worldwide, and educates and promotes the field through meetings, its journal Neuromodulation: Technology at the Neural Interface, and chapter websites. For more information, please visit www.neuromodulation.com.