8th World Congress & 11th Annual Meeting of the International Neuromodulation Society

The 8th world congress and 11th annual meeting of the International Neuromodulation Society (INS) was held at the Fairmont Princess Acapulco Hotel in picturesque Acapulco, Mexico. The conference held in December featured upcoming techniques in spinal cord and peripheral nerve stimulation, as well as several promising case reviews in the field of deep brain stimulation. New technologies were also showcased by presenters around the conference theme ‘Neuromodulation: Technology at the Neural Interface’.

New insights into deep brain stimulation, an emerging therapy used to treat a number of diseases of the brain, were presented by Dr Konstantin Baev of St Joseph’s Hospital, Arizona. The research conducted by Dr Baev is helping to boost the understanding of how neuromodulation works to improve Parkinson’s disease. Dr Baev’s model proposes that electrostimulation works on the parts of the brain involved in motor co-ordination by disrupting the errant neural impulses that are present in Parkinson’s disease. By disrupting these signals it is thought that symptoms such as resting tremor (the ‘shakes’) may be alleviated. It is hoped this model may be of benefit across a range of neuromodulation therapies.

A review of peripheral nerve field stimulation in the treatment of chronic pain was presented by Dr David Abejón of Peurta de Hierro University Hospital, Madrid. His investigation of peripheral nerve stimulation in areas inaccessible to spinal cord stimulation revealed a positive outcome for persistent non-cancer pain. A multicentre trial is expected to follow on from this research as a result of some very successful outcomes.

Dr Konstantin Slavin presented findings from a multicentre study investigating the efficacy of spinal cord stimulation (SCS) three months after implantation. The trial compared patient pain scores before and after implantation. In addition, changes in medication use, quality of life and side events were also assesed. It was found that the use of spinal cord stimulation decreased the pain rating by an average of 58.6 % in participants and resulted in an increase in quality of life. The technique also provided good to excellent pain control in up to 77.3% of patients with up to 81.8 % of patients reporting less reliance on paincontrolling medications following implantation.

Dr Bradley Carpentier discussed the effectiveness of SCS implantation across a range of chronic pain conditions. SCS appeared to be effective at relieving all pain complaints examined by the study with the exception of low back pain. Six months post implantation pain control was rated as improved in 30-90% of cases of refractory chronic pain. In addition, SCS was associated with relatively low rates of complications in this investigation.

On a similar note Dr Line Jacques discussed the effectiveness of Spinal cord stimulation as part of a treatment approach to manage pain in patients who have not gained any improvement from back surgery. Results from a randomised controlled study in 100 patients with neuropathic leg pain indicate that SCS can provide additional pain reduction and improvement in quality of life over a period of at least two years.

New technologies in SCS were showcased in the form of a novel Italian designed implant which utilises "Current fractionalisation" to reduce refractory low back pain. This device was trialled in a pilot study involving patients with unresolved back pain despite conventional SCS. The early results achieved with this device are promising and may lead to future improvement in control of unresolved low back pain.

The 3rd Scientific Meeting of the Australian Chapter of the International Neuromodulation Society will take place at the Perth Convention Centre on March 30, 2008. This meeting also incorporates The 28th Annual Scientific Meeting of the Australian Pain Society.

References

1. B Konstantin. Mechanisms of Deep Brain Stimulation in Parkinson’s Disease. Proceedings from the 11th annual meeting of the International Neuromodulation Society;2007 Dec 9-12;Acapulco, Mexico. Available from: URL:
   http://www.neuromodulation.com/uploads/files/2007-ins-nans-conference-oral-abstracts_104.pdf
2. Abejón D. An Initial Evaluation of Subcutaneous Stimulation for the Treatment of Chronic Pain. Proceedings from the 11th annual meeting of the International Neuromodulation Society;2007 Dec 9-12;Acapulco, Mexico. Available from: URL:
   http://www.neuromodulation.com/uploads/files/2007-ins-nans-conference-oral-abstracts_104.pdf
3. Slavin K. Prospective, multi-centered study to evaluate the safety and effectiveness of Genesis®
   Implantable Pulse Generator in combination with percutaneous leads for the management of chronic
   pain of the trunk and/or limbs. Proceedings from the 11th annual meeting of the International Neuromodulation Society;2007 Dec 9-12; Acapulco, Mexico. Available from: URL:
   http://www.neuromodulation.com/uploads/files/2007-ins-nans-conference-oral-abstracts_104.pdf
4. Carpentier B. Spinal Cord Stimulation indications and outcomes: A retrospective review. Proceedings from the 11th annual meeting of the International Neuromodulation Society; 2007 Dec 9-12; Acapulco, Mexico. Available from: URL:
   http://www.neuromodulation.com/uploads/files/2007-ins-nans-conference-oral-abstracts_104.pdf
5. Jacques L. Spinal cord stimulation versus conventional medical management: Long-term results from a
   multicentre randomised controlled trial of patients with failed back surgery syndrome: (PROCESS study).Proceedings from the 11th annual meeting of the International Neuromodulation Society;2007 Dec 9-12; Acapulco, Mexico. Available from: URL:
   http://www.neuromodulation.com/uploads/files/2007-ins-nans-conference-oral-abstracts_104.pdf
6. Reverberi C. Successful Treatment of Chronic Axial Low Back Pain and Bilateral Radicular Leg Pain in Two
   Cases of Failed Back Syndrome (FBSS) and Lumbar Spondylosis with a New Technique of Spinal
   Cord Stimulation (SCS) : The “Electrical Fractionalization”. Proceedings from the 11th annual meeting of the International Neuromodulation Society;2007 Dec 9-12; Acapulco, Mexico. Available from: URL:
   http://www.neuromodulation.com/uploads/files/2007-ins-nans-conference-oral-abstracts_104.pdf