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The Evolution of Neuromodulation in the Treatment of Chronic Pain: Forward-Looking Perspectives

机译：慢性疼痛治疗中神经调节的演变：前瞻性观点

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Background. The field of neuromodulation is continually evolving, with the past decade showing significant advancement in the therapeutic efficacy of neuromodulation procedures. The continued evolution of neuromodulation technology brings with it the promise of addressing the needs of both patients and physicians, as current technology improves and clinical applications expand. Design. This review highlights the current state of the art of neuromodulation for treating chronic pain, describes key areas of development including stimulation patterns and neural targets, expanding indications and applications, feedback-controlled systems, noninvasive approaches, and biomarkers for neuromodulation and technology miniaturization. Results and Conclusions. The field of neuromodulation is undergoing a renaissance of technology development with potential for profoundly improving the care of chronic pain patients. New and emerging targets like the dorsal root ganglion, as well as high-frequency and patterned stimulation methodologies such as burst stimulation, are paving the way for better clinical outcomes. As we look forward to the future, neural sensing, novel target-specific stimulation patterns, and approaches combining neuromodulation therapies are likely to significantly impact how neuromodulation is used. Moreover, select biomarkers may influence and guide the use of neuromodulation and help objectively demonstrate efficacy and outcomes.
机译：背景。随着过去的十年，神经调节领域正在不断发展，显示出神经调节程序的治疗效果的显着提高。随着目前的技术改善和临床应用扩展，持续的患有患者和医生需求的持续演变带来了解决患者和医生的需求。设计。本综述凸显了治疗慢性疼痛的神经调节艺术的现状，描述了关键的发展领域，包括刺激模式和神经目标，扩展适应症和应用，反馈控制的系统，非侵入性方法以及用于神经调节和技术小型化的生物标志物。结果与结论。神经调节领域正在进行一种技术开发的复兴，具有深刻改善慢性疼痛患者的护理。像背根神经节一样新的和新兴的目标，以及高频和图案化的刺激方法，如爆发刺激，正在为更好的临床结果铺平道路。随着我们期待未来，神经传感，新的靶特异性刺激模式，以及组合神经调节疗法的方法可能会显着影响所使用的神经调节方式。此外，选择生物标志物可能会影响和指导使用神经调节，并有助于客观地展示疗效和结果。

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