What is neuromodulation? The World Neuromodulation Society (INS) defines neuromodulation as a biomedical engineering technique that uses implantable or non-implantable technology to modify the activity of the central, peripheral, or autonomic nervous system using electrical stimulation or drugs to improve the symptoms and quality of life of people with the condition.
The application of modern neuromodulation techniques began in the 1960s when Melzack and Wall proposed the theory of pain gate control, after which spinal cord stimulation (SCS) was gradually used to treat chronic intractable pain, followed by deep brain electrical stimulation (DBS), vagus nerve stimulation (VNS), and cortical stimulation (CS).
Neuromodulation is currently used to treat Parkinson’s disease, dystonia, depression, epilepsy, pain, idiopathic tremor, obsessive-compulsive disorder, and other functional neurosurgical disorders.
The neuromodulation center of neurosurgery department of Shengjing Hospital of China Medical University, relying on the complete and advanced medical platform of the hospital, under the multidisciplinary cooperation mode led by Professor Liu Yunhui, vice president and director of neurosurgery department, takes the above diseases as the main treatment target and introduces a whole set of talents and equipment, becoming the most comprehensive, advanced equipment and first-class technology unit in the northeast region to carry out neuromodulation treatment projects, using the latest We use the latest neuromodulation treatment technology to serve our patients.
Vagus nerve stimulation (VNS)
VNS is a technique to suppress seizures and control depressive states through electrical stimulation of the vagus nerve. The treatment requires a single session of VNS, which is performed on the vagus nerve.
For whom is vagus nerve stimulation suitable?
This technique is indicated for patients with drug-refractory epilepsy (partial and generalized seizures) and drug-refractory depression.
It has been used to treat refractory epilepsy since 1998, and currently more than 30,000 patients have been treated with this technique.
In addition, in addition to reducing seizures, studies in recent years have also shown that the treatment can also improve patients’ mood and depression scores, and since 2004, VNS has been used to treat depression with good results.
Dr. Bao Min of the Department of Neurosurgery, Shengjing Hospital, China Medical University, is one of the most experienced specialists in this procedure in China, and has accumulated a wealth of experience in surgery and postoperative program control.
Deep Brain Electrical Stimulation [DBS]
DBS technique is a surgical method to treat Parkinson’s disease, dystonia, idiopathic tremor, epilepsy, and tic obscura syndrome by precisely placing fine electrodes with a diameter of about 2mm into specific nuclei in the brain and stimulating them with pulsed current through a pulse generator placed under the skin of the chest. Its characteristics are demonstrated by the following.
DBS is reversible and modifiable. The surgery does not destroy the nucleus, but only temporarily paralyzes it electrically and improves the nerve function. The degree and extent of nerve nucleus paralysis can be adjusted by setting the current, voltage, frequency and electrode position of the deep brain electrodes. It can also be adjusted continuously after the operation as the disease changes, which can control the evolving and changing Parkinson’s disease symptoms in the long term.
The effects of DBS treatment can be experienced. After surgical implantation of electrodes, temporary stimulation can be used to give the patient and family a few days of adaptation, experience and observation before deciding on the final and best surgical plan. Reducing the inaccuracy of previous surgeries in determining efficacy due to patient stress and other factors.
DBS is evolvable. Surgery preserves the neurological function of normal brain tissue, creating the conditions for new approaches that may emerge later, and thus preserves the patient’s right and hope for a new life.
DBS is bilaterally treatable at the same time. Patients with Parkinson’s disease are affected bilaterally, and the fact that DBS can stimulate both sides at the same time with very few side effects is an important reason why patients are happy to receive DBS treatment.
Because of these advantages, more and more patients are being treated with pacemakers (DBS). In China, a considerable number of cases of Parkinson’s disease, dystonia, idiopathic tremor, epilepsy, and tic obscura syndrome have been treated since 1998, and this procedure has been carried out in the Department of Neurosurgery of Shengjing Hospital of China Medical University, allowing this patient to
The procedure has been carried out in the Department of Neurosurgery of Shengjing Hospital of China Medical University, allowing the patients to have a normal life to the maximum extent.
In addition to the above-mentioned diseases, DBS technology has recently been used to treat functional brain disorders such as obsessive-compulsive disorder, severe depression, severe anxiety and phobias, anorexia nervosa, torsional spasm, spastic diastasis, and Tourette’s syndrome, with good results as well.
Spinal Cord Electrical Stimulation Surgery [SCS
Spinal cord electrical stimulation (SCS) is a treatment method that applies electrical stimulation to the corresponding spinal cord according to the nature of the patient’s pain and the location of the pain. SCS involves implanting stimulation electrodes in the epidural space of the spinal cord of patients with intractable pain, burying a matchbox-sized stimulator under the skin of the patient’s abdomen, and implementing neuromodulation to replace the pain sensory information from peripheral sensory nerves with a tolerable tingling sensation before it reaches the brain, thus providing great relief. The patient can control the stimulator with the remote control in his hand
The patient can control the magnitude of the pulse current to freely relieve and alleviate the pain sensation.
The SCS system consists of three parts: electrodes, extension leads, and nerve stimulators. All parts are buried under the skin and are not visible from the outside. Important parameters such as stimulation contacts, stimulation pulse width, voltage and frequency can be adjusted according to the condition by the doctor through a special extracorporeal program control device.
Currently SCS is mainly used for intractable chronic pain.
Low back pain: this is the most treated condition by SCS, with failure of lumbar spine surgery syndrome (failedbacksurgerysyndrom, FBSS, mainly postoperative pain from lumbar disc herniation) being the main one.
Other pains: Many studies have shown that SCS has different degrees of analgesic effects on pains such as post-herpetic neuralgia, phantom pain, peripheral nerve injury, trigeminal neuralgia, cancer pain, thrombotic vasculitis, spinal cord injury, and reflexive sexual dystrophy.
In addition, spinal cord electrical stimulation has been used in recent years to promote the waking up treatment of vegetative patients, and has also achieved good efficacy. A number of units nationwide have carried out treatment to promote the waking up of vegetative patients, and the Department of Neurosurgery of Shengjing Hospital of China Medical University has also carried out the above treatment work.