Affiliation:
1. Division of Pain Medicine, Department of Anesthesia, New York University Grossman School of Medicine, New York,
NY, USA
Abstract
Abstract:
The percutaneous technique of electrode insertion in the vicinity of the greater occipital
nerves to treat occipital neuralgia was first described in the 1990s by Weiner and Reed. This subsequently
stimulated awareness of peripheral nerve stimulation (PNS). The more recent advent emergence
of a minimally invasive percutaneous approach by way of using ultrasound has further increased
the interest in PNS as a viable alternative to more invasive techniques. PNS has become more popular
recently and is increasingly used to treat various pain conditions. Its foundation is fundamentally
based on the gate control theory, although the precise mechanism underlying its analgesic effect is still
indefinite. Studies have demonstrated the peripheral and central analgesic mechanisms of PNS by
modulating the inflammatory pathways, the autonomic nervous system, the endogenous pain inhibition
pathways, and the involvement of the cortical and subcortical areas. Peripheral nerve stimulation
exhibits its neuromodulatory effect both peripherally and centrally. Further understanding of the modulation
of PNS mechanisms can help guide stimulation approaches and parameters to optimize the use
of PNS. his chapter aims to review the background and mechanisms of PNS modulation. PNS is becoming
one of the most diverse therapies in neuromodulation due to rapid evolution and expansion. It
is an attractive option for clinicians due to the simplicity and versatility of procedures that can be
combined with other neuromodulation treatments or used alone. It has a distinct role in the modulation
of functional conditions.
Publisher
Bentham Science Publishers Ltd.
Subject
Pharmacology (medical),Psychiatry and Mental health,Neurology (clinical),Neurology,Pharmacology,General Medicine