Tim Vancamp

Fusion for Energy

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Dirk De Ridder

University of Otago

Sven Vanneste

Trinity College Dublin

Mark Plazier

Jessa Hospital

Elsa van der Loo

Antwerp University Hospital

David Logé

Ibero American University

Mathieu W.P.M. Lenders

Medisch Spectrum Twente

Mercé Falip

Institut d'Investigació Biomédica de Bellvitge

Cecile C. de Vos

Erasmus University Rotterdam

Pieter Van Looy

GZA Ziekenhuizen Campus Sint-Augustinus

Wim Pollet

Cooperative Institutions

Hospital Universitari Germans Trias i Pujol

Bellvitge University Hospital

Institut d'Investigació Biomédica de Bellvitge

Universitat de Barcelona

Universitat Autònoma de Barcelona

Antwerp University Hospital

University of Antwerp

Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol

Medisch Spectrum Twente

Sint Maartenskliniek

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Mimicking the brain: evaluation of St Jude Medical’s Prodigy Chronic Pain System with Burst Technology

Expert Review of Medical Devices (2014)

Dirk De Ridder Sven Vanneste Mark Plazier Tim Vancamp

The Prodigy is a new type of internal pulse generator that controls the delivery of electrical stimuli to nervous tissue. It is capable of delivering burst stimulation, which is a novel waveform that consists of closely spaced high-frequency electrical impulses delivered in packets riding on a plateau, and followed by a quiescent period. Its inception was based on mimicking burst firing in the nervous system and usually delivered by unmyelinated fibers that uniformly have a motivational affective homeostatic function. It thereby targets a multimodal salience network, even though the stimuli are delivered at the level of the spinal cord. As such, it is specifically capable of influencing the affective/attentional components of pain. Burst stimulation was initially safely applied off-label to the auditory cortex for tinnitus, and later also to the spinal cord, the somatosensory cortex for neuropathic pain, subcutaneously for failed back surgery syndrome, and cingulate cortex for addiction and tinnitus.

10.1586/17434440.2015.985652

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Citations (57)

A 2-center Comparative Study on Tonic Versus Burst Spinal Cord Stimulation

Clinical Journal of Pain (2014)

Dirk De Ridder Mathieu W.P.M. Lenders Cecile C. de Vos Cindy Dijkstra-Scholten Rian Wolters

Spinal cord stimulation is a safe and effective procedure applied for medically intractable neuropathic pain and failed back surgery syndrome. Recently, a novel stimulation paradigm was developed, called burst stimulation consisting of intermittent packets of closely spaced high-frequency stimuli. The design consists of 40 Hz burst mode with 5 spikes at 500 Hz per burst, with a pulse width of 1 ms and 1 ms interspike interval delivered in constant current mode.A retrospective analysis is performed looking at 102 patients from 2 neuromodulation centers, 1 in Belgium and 1 in the Netherlands. This consisted of 2 groups, 1 group who had become failures to tonic (conventional) stimulation and 1 group who still responded to tonic stimulation. All patients were switched from tonic to burst stimulation and the amount of responders as well as the amount of pain suppression was assessed.Overall burst stimulation was significantly better than tonic stimulation and baseline. On average the pain on numeric rating scale (NRS) improved from 7.8 at baseline to 4.9 with tonic to 3.2 with burst stimulation. For the Belgian and Dutch centers combined, 62.5% of nonresponders to tonic stimulation did respond to burst stimulation, on average, with 43% pain suppression. Most responders to tonic further improved with burst stimulation; on average, pain suppression improved from 50.6% to 73.6.3%. The results (from both centers) did not differ for the amount of obtained pain suppression, only for the amount of responders, which could be related to the different profile of the 2 participating centers.Burst seems to be significantly better than tonic stimulation. It can rescue an important amount of nonresponders to tonic stimulation and can further improve pain suppression in responders to tonic stimulation.

Tonic (physiology)

10.1097/ajp.0000000000000129

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All bursts are equal, but some are more equal (to burst firing): burstDR stimulation versus Boston burst stimulation

Expert Review of Medical Devices (2020)

Dirk De Ridder Tim Vancamp Steven Falowski Sven Vanneste

Introduction: Since the introduction of burst spinal cord stimulation for neuropathic pain, several companies have developed their own version of burst stimulation, which is confusing the marketplace and clinicians of what burst stimulation truly is, the value and utilization of the therapy.Areas covered: We review those two burst stimulation designs and notice important differences. The original burstDRTM stimulation tries to mimic physiologic burst firing, which involves closely spaced high frequency sodium spikes nested on a calcium mediated plateau. This is realized by generating a train of 5 monophasic spikes of increasing amplitude with passive charge balance after the last spike, in contrast to the other burst designs which involve a version of cycling 4-5 spikes each being individually actively charge balanced spikes.Expert opinion: Based on the neurobiology of burst firing as well as abductive reasoning we like to clarify that burstDRTM is a true physiologic burst stimulation, and that other versions being called burst stimulation are essentially clustered tonic stimulation. This differentiating terminology will prevent confusion for healthcare providers, regulators, and the marketplace of what burst stimulation is.

Bursting

Burst suppression

10.1080/17434440.2020.1736560

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Citations (31)

Percutaneously Implanted Plates in Failed Back Surgery Syndrome (FBSS)

Neuromodulation Technology at the Neural Interface (2011)

Leon H. Vonhögen Tim Vancamp Sven Vanneste Wim Pollet Ris Dirksen

Failed back surgery

Back Pain

Spinal cord stimulator

10.1111/j.1525-1403.2011.00368.x

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Citations (15)

Long-Term Outcomes of Spinal Cord Stimulation With Percutaneously Introduced Paddle Leads in the Treatment of Failed Back Surgery Syndrome and Lumboischialgia

Neuromodulation Technology at the Neural Interface (2013)

David Logé Sven Vanneste Tim Vancamp Dirk Rijckaert

Spinal cord stimulator

Failed back surgery

Back Pain

10.1111/ner.12012

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Citations (12)

Is Preoperative Pain Duration Important in Spinal Cord Stimulation? A Comparison Between Tonic and Burst Stimulation

Neuromodulation Technology at the Neural Interface (2014)

Dirk De Ridder Tim Vancamp Mathieu W.P.M. Lenders Cecile C. de Vos Sven Vanneste

Tonic (physiology)

10.1111/ner.12253

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Citations (28)

Clinical Aspects of Burst Stimulation for Pain Control

Elsevier eBooks (2018)

Stefan Schu Tim Vancamp

Pain control

10.1016/b978-0-12-805353-9.00052-8

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A Novel Percutaneous Technique to Implant Plate-Type Electrodes

min - Minimally Invasive Neurosurgery (2011)

David Logé Olivier De Coster Wim Pollet Tim Vancamp

In spinal cord stimulation (SCS) mainly 2 distinctive implantation techniques can be recognized: the percutaneous and surgical technique.A puncture is made with a blunt 14 gauge Tuohy needle. Once inside the epidural space the guide wire needs to be advanced in the epidural space, then the Tuohy needle is removed. The Epiducer is advanced under the guidance of lateral fluoroscopy, to confirm epidural entry. The S-series electrode is introduced through the sheet in the epidural space.We present a novel technique to introduce small profile paddle leads (S-Series™: St. Jude Medical - Neuromodulation Division, Plano, TX) in the epidural space via a percutaneous approach using the Epiducer™ (St. Jude Medical - Neuromodulation Division, Plano, TX) lead delivery system.

Tuohy needle

Epidural space

Neuromodulation

Spinal cord stimulator

Medical device

10.1055/s-0031-1287830

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Citations (12)

Post-Operative Localization of Deep Brain Stimulation Electrodes in the Subthalamus Using Transcranial Sonography

Neuromodulation Technology at the Neural Interface (2017)

Lourdes Ispierto Jorge Muñoz Josep Maria Cladellas Patricia Cuadras Jaume Capellades

Subthalamic Nucleus