Anatomo-physiological basis and applied techniques of electrical neuromodulation in chronic pain.
Authors: Guzzi G, Della Torre A, Bruni A, Lavano A, Bosco V, Garofalo E, La Torre D, Longhini F
Chronic pain, a complex and debilitating condition, poses a significant challenge to both patients and healthcare providers worldwide. Conventional pharmacological interventions often prove inadequate in delivering satisfactory relief while carrying the risks of addiction and adverse reactions. In recent years, electric neuromodulation emerged as a promising alternative in chronic pain management. This method entails the precise administration of electrical stimulation to specific nerves or regions within the central nervous system to regulate pain signals. Through mechanisms that include the alteration of neural activity and the release of endogenous pain-relieving substances, electric neuromodulation can effectively alleviate pain and improve patients' quality of life. Several modalities of electric neuromodulation, with a different grade of invasiveness, provide tailored strategies to tackle various forms and origins of chronic pain. Through an exploration of the anatomical and physiological pathways of chronic pain, encompassing neurotransmitter involvement, this narrative review offers insights into electrical therapies' mechanisms of action, clinical utility, and future perspectives in chronic pain management.
Introduction
Purpose
Other
Study Objective
To provide a comprehensive review of the neuroanatomy and neurophysiology of chronic pain with emphasis on the mechanisms, clinical utility, and future perspectives of electrical neuromodulation.
Disease model
Chronic pain
Outcomes and Safety
Summary of Outcomes
Electrical neuromodulation modulates neural activity and endogenous analgesic pathways to alleviate chronic pain and improve patients' quality of life; no focused ultrasound parameters were tested or reported as successful in this review.
Safety-related matter
The paper notes conventional pharmacological treatments carry risks of addiction and adverse reactions. It also highlights that neuromodulation techniques vary in invasiveness and that invasiveness should be proportionate to patient clinical status, implying safety considerations and the need for careful patient selection.
Brain Region
Ultrasound Parameters
Focal Characteristics
Focal depth: None; Focal length: None; Aperture size: None
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