The Experts below are selected from a list of 14283 Experts worldwide ranked by ideXlab platform
Edelle C Fieldfote - One of the best experts on this subject based on the ideXlab platform.
-
Neuromodulation in the restoration of function after spinal cord injury
Lancet Neurology, 2018Co-Authors: Nicholas D James, Stephen B Mcmahon, Edelle C Fieldfote, Elizabeth J BradburyAbstract:Summary Neuromodulation, the use of electrical interfaces to alter neuronal activity, has been successful as a treatment approach in several neurological disorders, including deep brain stimulation for Parkinson's disease and epidural spinal stimulation for chronic pain. Neuromodulation can also be beneficial for spinal cord injury, from assisting basic functions such as respiratory pacing and bladder control, through to restoring volitional movements and skilled hand function. Approaches range from electrical stimulation of peripheral muscles, either directly or via brain-controlled bypass devices, to stimulation of the spinal cord and brain. Limitations to widespread clinical application include durability of Neuromodulation devices, affordability and accessibility of some approaches, and poor understanding of the underlying mechanisms. Efforts to overcome these challenges through advances in technology, together with pragmatic knowledge gained from clinical trials and basic research, could lead to personalised neuromodulatory interventions to meet the specific needs of individuals with spinal cord injury.
Philip Van Kerrebroeck - One of the best experts on this subject based on the ideXlab platform.
-
advances in the role of sacral nerve Neuromodulation in lower urinary tract symptoms
International Urogynecology Journal, 2010Co-Authors: Philip Van KerrebroeckAbstract:Sacral Neuromodulation has been developed to treat chronic lower urinary tract symptoms, resistant to classical conservative therapy. The suspected mechanisms of action include afferent stimulation of the central nervous system and modulation of activity at the level of the brain. Typical Neuromodulation is indicated both in overactivity and in underactivity of the lower urinary tract. In the majority of patients, a unilateral electrode in a sacral foramen and connected to a pulse generator is sufficient to achieve significant clinical results also on long term. In recent years, other urological indications have been explored.
Nicholas D James - One of the best experts on this subject based on the ideXlab platform.
-
Neuromodulation in the restoration of function after spinal cord injury
Lancet Neurology, 2018Co-Authors: Nicholas D James, Stephen B Mcmahon, Edelle C Fieldfote, Elizabeth J BradburyAbstract:Summary Neuromodulation, the use of electrical interfaces to alter neuronal activity, has been successful as a treatment approach in several neurological disorders, including deep brain stimulation for Parkinson's disease and epidural spinal stimulation for chronic pain. Neuromodulation can also be beneficial for spinal cord injury, from assisting basic functions such as respiratory pacing and bladder control, through to restoring volitional movements and skilled hand function. Approaches range from electrical stimulation of peripheral muscles, either directly or via brain-controlled bypass devices, to stimulation of the spinal cord and brain. Limitations to widespread clinical application include durability of Neuromodulation devices, affordability and accessibility of some approaches, and poor understanding of the underlying mechanisms. Efforts to overcome these challenges through advances in technology, together with pragmatic knowledge gained from clinical trials and basic research, could lead to personalised neuromodulatory interventions to meet the specific needs of individuals with spinal cord injury.
Cindy L Amundsen - One of the best experts on this subject based on the ideXlab platform.
-
cost effectiveness of sacral Neuromodulation versus onabotulinumtoxina for refractory urgency urinary incontinence results of the rosetta randomized trial
The Journal of Urology, 2020Co-Authors: Heidi S Harvie, Cindy L Amundsen, Simon Neuwahl, Amanda Honeycutt, Emily S Lukacz, Vivian W Sung, Rebecca G Rogers, David R Ellington, Cecile A FerrandoAbstract:Purpose:Sacral Neuromodulation and intradetrusor onabotulinumtoxinA injection are therapies for refractory urgency urinary incontinence. Sacral Neuromodulation involves surgical implantation of a d...
-
sacral Neuromodulation versus onabotulinumtoxina for refractory urgency urinary incontinence impact on fecal incontinence symptoms and sexual function
American Journal of Obstetrics and Gynecology, 2019Co-Authors: Uduak U Andy, Cindy L Amundsen, Emily Honeycutt, Alayne D Markland, Gena C Dunivan, Keisha Y Dyer, Nicole B Korbly, Megan S Bradley, Sandip P Vasavada, Donna MazloomdoostAbstract:Background Women with refractory urgency urinary incontinence can be treated with onabotulinumtoxinA or sacral Neuromodulation. Little data exists on the comparative effects of treatment of refractory urgency urinary incontinence on other pelvic floor complaints, such as bowel and sexual function. Objective The objective of this study was to compare the impact of these treatments on fecal incontinence and sexual symptoms. Methods This was a planned supplemental analysis of a randomized trial in women with refractory urgency urinary incontinence treated with onabotulinumtoxinA (n = 190) or sacral Neuromodulation (n = 174). Fecal incontinence and sexual symptoms were assessed at baseline and at 6, 12, and 24 months. Fecal incontinence symptoms were measured using the St Mark’s (Vaizey) Fecal Incontinence severity scale. Sexual symptoms were measured using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) and the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR). The PISQ-IR allows measurement of sexual symptoms in both sexually active and non–sexually active adults. Primary outcomes were change in Vaizey and PISQ-12 scores between baseline and 6 months. Secondary outcomes were change in PISQ-IR total and subscores between baseline and 6 months and change in Vaizey, PISQ-12, and PISQ-IR scores between baseline and 12 and 24 months. Intent-to-treat analysis was performed using repeated measures mixed model to estimate change in all parameters from baseline while adjusting for the baseline score. A subgroup analysis of women with clinically significant bowel symptoms was conducted based on baseline Vaizey score of ≥12. Results At baseline, mean Vaizey scores were indicative of mild fecal incontinence symptoms and were not different between onabotulinumtoxinA and sacral Neuromodulation groups (7.6 ± 5.3 vs 6.6 ± 4.9, P = .07). The proportion of sexually active women (56% vs 63%, P = .25), mean PISQ-12 score (33.4 ± 7.5 vs 32.7 ± 6.7, P = .55), or PISQ-IR subscores were also not different between the onabotulinumtoxinA and sacral Neuromodulation groups at baseline. There was no difference between women treated with onabotulinumtoxinA and those treated with sacral Neuromodulation at 6 months in terms of improvement in fecal incontinence symptom score (Vaizey: -1.9, 95% confidence interval -2.6 to -1.2 vs -0.9, 95% confidence interval -1.7 to -0.2, P = .07) or sexual symptoms score (PISQ-12: 2.2, 95% confidence interval 0.7 to 3.7 vs 2.2, 95% confidence interval 0.7 to 3.7, P = .99). There was no difference in improvement between groups in the sexual symptom subscores in sexually active and non–sexually active women at 6 months. Similar findings were noted at 12 and 24 months. In a subgroup (onabotulinumtoxinA = 33 and sacral Neuromodulation = 22) with clinically significant fecal incontinence at baseline (Vaizey score ≥12), there was a clinically meaningful improvement in symptoms in both groups from baseline to 6 months, with no difference in improvement between the onabotulinumtoxinA and sacral Neuromodulation groups (-5.1, 95% confidence interval -7.3 to -2.8 vs -5.6, 95% confidence interval -8.5 to -2.6, P = .8). Conclusion There were no differences in improvement of fecal incontinence and sexual symptoms in women with urgency urinary incontinence treated with onabotulinumtoxinA or sacral Neuromodulation. Women with significant fecal incontinence symptoms at baseline had clinically important improvement in symptoms, with no difference between the treatments. Our findings can help clinicians counseling women considering treatment for refractory urgency urinary incontinence.
Elizabeth J Bradbury - One of the best experts on this subject based on the ideXlab platform.
-
Neuromodulation in the restoration of function after spinal cord injury
Lancet Neurology, 2018Co-Authors: Nicholas D James, Stephen B Mcmahon, Edelle C Fieldfote, Elizabeth J BradburyAbstract:Summary Neuromodulation, the use of electrical interfaces to alter neuronal activity, has been successful as a treatment approach in several neurological disorders, including deep brain stimulation for Parkinson's disease and epidural spinal stimulation for chronic pain. Neuromodulation can also be beneficial for spinal cord injury, from assisting basic functions such as respiratory pacing and bladder control, through to restoring volitional movements and skilled hand function. Approaches range from electrical stimulation of peripheral muscles, either directly or via brain-controlled bypass devices, to stimulation of the spinal cord and brain. Limitations to widespread clinical application include durability of Neuromodulation devices, affordability and accessibility of some approaches, and poor understanding of the underlying mechanisms. Efforts to overcome these challenges through advances in technology, together with pragmatic knowledge gained from clinical trials and basic research, could lead to personalised neuromodulatory interventions to meet the specific needs of individuals with spinal cord injury.
