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Neuromodulation and palliative medicine.

Howard S Smith1, Julie G Pilitsis

  • 11Department of Anesthesiology, Albany Medical College, Albany, NY, USA.

The American Journal of Hospice & Palliative Care
|March 28, 2013
PubMed
Summary

Neuromodulation techniques, like spinal cord stimulation, may offer advantages over systemic medications for palliative care patients. Future research could explore brain electrical stimulation for severe refractory symptoms.

Keywords:
braindyspneaelectricalnauseaneuromodulationpainpalliative carestimulation

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Area of Science:

  • Palliative Care Medicine
  • Neuroscience
  • Medical Technology

Background:

  • Palliative care patients are susceptible to adverse drug effects and interactions.
  • Systemic medications may present challenges in this vulnerable population.
  • Neuromodulation offers a potential alternative to traditional pharmacotherapy.

Purpose of the Study:

  • To review the potential benefits of neuromodulation in palliative care.
  • To explore the application of neuromodulation for refractory symptoms.
  • To highlight the need for further investigation into brain electrical stimulation.

Main Methods:

  • Literature review of neuromodulation techniques in pain management.
  • Discussion of current and potential applications of neuromodulation in palliative care.
  • Analysis of existing evidence for spinal cord, peripheral nerve, and brain electrical stimulation.

Main Results:

  • Spinal cord and peripheral nerve stimulation are established for analgesia.
  • Deep brain stimulation/motor cortex stimulation has anecdotal use for intractable pain.
  • Brain electrical stimulation shows potential for refractory symptoms like pain, nausea, dyspnea, and delirium.

Conclusions:

  • Neuromodulation presents a promising avenue for symptom management in palliative care.
  • Further clinical trials are needed to validate the efficacy of brain electrical stimulation.
  • Neuromodulation may reduce reliance on systemic medications in palliative patients.