Neuromodulation: Mechanisms of action

Abstract

Neuromodulation may refer to spinal cord stimulation (SCS), peripheral nerve stimulation (PNS), or peripheral nerve field stimulation for the treatment of chronic pain. All neurostimulation treatments share common mechanisms of action that affect the nervous system in order to suppress pain, but each modality seems to have its own unique and particular mechanisms. Multiple clinical and animal studies to date have revealed that neurostimulation therapy involves a complex interaction with multiple structures in the nervous system, with the effect not just attributed to the gate control theory, as initially believed. Improved understanding has led to the development of high-frequency, burst waveform, and dorsal root ganglion (DRG) stimulation.