The StimRouter a Potential Advance in Neuropathy Treatment

Today's post comes from americannewsreport.com (see link below)and talks about a new form of electro-stimulator designed to inhibit nerve pain. It's still in the testing stage so as with all these things, "seeing is believing". The biggest difference in comparison to other electrostimulators is that this one will be applied directly at the source of the pain and not just the spine. The problem with neuropathy is that although we may say that our pain is in the hands, feet or legs, it's always difficult to specify precisely where the source of the pain lies. The article suggests that the StimRouter will apply current directly to the nerve which transmits pain signals to the brain.

Device Could Deliver Chronic Nerve Pain Relief Without Drugs
by Staff on April 12, 2012

A southern California company has begun a study to evaluate the safety and effectiveness of the “StimRouter” neuromodulation system for sufferers of chronic peripheral nerve pain. Bioness will enroll 126 patients in up to 10 sites in the U.S. for the study, which will take over two years to complete.

“The StimRouter could potentially provide – for the first time – a non-pharmaceutical treatment option that can be targeted directly to the pain site for more focused pain relief. The results of this study could have a significant impact on the way we treat patients with peripheral nerve pain,” said Timothy Deer, MD, a pain management specialist at The Center for Pain Relief at Saint Francis Hospital in Charleston, West Virginia.

20 million Americans suffer from chronic peripheral nerve pain. The disorder triggers painful burning and tingling sensations, or feeling like “pins and needles.” Current treatments include spinal cord stimulation and pain medication. Because of rising abuse, addiction and deaths from painkillers, many patients and health care providers are looking for alternate ways to relieve pain.

Unlike other neurostimulators, the StimRouter is designed to be used at the pain site rather than the spinal cord. It delivers low-level electrical impulses directly to the nerve that carries the pain signal to the brain. The device also has the capability of storing stimulation programs to provide patients with a variety of treatment options depending on their activity or level of pain.

The study will evaluate the effect of the system on patients’ overall pain, as well as changes in pain medication, quality of life, changes in pain level, patient satisfaction and long-term safety.

http://americannewsreport.com/device-could-deliver-chronic-nerve-pain-relief-without-drugs-8813832.html

Can a high CD4 cell count cause neuropathic pain

Today's post from EATG: the European Aids Treatment Group, (see link below)is based on a study of 1,539 HIV-patients by the University of California. It reveals much of what most of us already know but interestingly also, the fact that a high CD4 cell count (which we all use as a measure of immune system health) can be a possible cause of neuropathic pain. Not really what we want to hear when we're spending every waking minute trying to boost that very cell count. The article suggests that it may be a consideration when deciding whether to start anti retroviral treatment in the first place. Considering that the current thinking is that it's better all round, to start as soon as possible, the dilemma is obvious. On the other hand, there's not really much of a choice is there? The medication which halts viral development is more or less essential and for some people, the pain may be an unwelcome but necessary by-product.

Debilitating HIV-associated sensory neuropathy remains common
20/05/2010

Debilitating sensory neuropathy remains prevalent in HIV-infected patients, despite a general decline of neurological complications with use of combination antiretroviral therapy.

This finding is from a study in which the researchers tested 1,539 HIV-infected individuals for clinical signs of neuropathy and neuropathic pain.

"We were surprised by the high prevalence," lead author Dr. Ronald Ellis of the University of California, San Diego, told Reuters Health by e-mail.

"Painful neuropathy frequently persists and requires ongoing management," even when antiretroviral therapy has reduced viral load and restored immune function, he said.

In the May Archives of Neurology, Dr. Ellis and colleagues report that 881 patients (57.2%) had HIV-associated sensory neuropathy, and 335 of those 881 (38.0%) had neuropathic pain.

"Neuropathic pain was significantly associated with disability in daily activities, unemployment, and reduced quality of life," the investigators say.

Patients currently taking combination antiretroviral therapy had an adjusted odds ratio of 1.60 for clinical signs of sensory neuropathy, compared to past users or never users of antiretroviral combinations.

Age (aOR 2.13), past use of stavudine, didanosine, or zalcitabine (aOR 1.95), and lower CD4 nadir (aOR 1.16) were also associated with sensory neuropathy.

Paradoxically, neuropathic pain was associated with a higher CD4 nadir, as well as with past use of stavudine, didanosine, or zalcitabine.

In an editorial, Drs. Dennis Kolson and Francisco Gonzalez-Scarano, both of the University of Pennsylvania in Philadelphia, said the "association between neuropathic pain and a higher CD4 nadir suggests that a functional immune system may contribute to the induction of pain." They also suggest considering the risk of neuropathy - and the disability that results -- when deciding whether to start antiretroviral therapy.

Regarding potential for peripheral nerve regeneration and recovery, Dr. Ellis told Reuters Health, "It may be that treatments can be designed to enhance regeneration. Alternatively, we may find that earlier HAART therapy using agents without neurotoxicity can protect individuals from developing neuropathy in the first place."

By Dave Levitan
Medscape Today

http://eatg.org/eatg/Global-HIV-News/Treatment/Debilitating-HIV-associated-sensory-neuropathy-remains-common

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