A Message from the President
Dear INS members and friends,
As I write this message, I have just returned from previewing the location of our 13th biennial congress, “Neuromodulation: Technology Changing Lives.” The INS World Congress will take place in Edinburgh from May 27 – June 1, 2017.
Looking at newly expanded, modern venue in this historic city, I was struck by how the INS is moving up to accommodate ever-increasing, international interest in our field. The flexible, spacious design of the Edinburgh International Conference Centre will allow our meeting to grow to welcome more delegates while keeping the interactive and personal tone that has characterized our events. The staff was superb and the ease of access was equally notable, with the venue near both the international airport and historic city center. Edinburgh is a strikingly beautiful city with a rich and fascinating medical history.
We spent some time there conferring on final drafts of the new INS committee structure. The plans include a request, emailed to members, for final recommendations. Our vision is that committees will help guide implementation of how we put our dedication to education, service, and the best patient-care standards into practice.
In this issue is the final installment of 25th-year-anniversary recollections by early pioneers. Benelux Neuromodulation Society President Mike DeJongste, MD, PhD has set forth the impetus for the initial meetings that led to the society’s formation. Even at the dawn of the INS in 1989, the society’s unique multidisciplinary nature was evident. An emphasis on quality standards, interest in mechanisms of action, and international presence on the board were present from the earliest days – common threads that continue today.
Another development in progress is preparation of updated treatment guidelines for intrathecal therapy and neurostimulation. The draft reports of the Neuromodulation Appropriateness Consensus Committee and Polyanalgesic Consensus Conference (NACC/PACC) are nearly ready for consensus editing. The updates are anticipated to be submitted for publication in the first half of 2016 in Neuromodulation: Technology at the Neural Interface. As the most comprehensive international guidelines concerning these therapies, the reports should guide neuromodulation for pain going forward.
Several chapters have joint or individual annual scientific meetings in the coming months – please see more about that in the rest of this newsletter, as well as listings on the INS Global Events Calendar. Congratulations to all for your important work that makes up-to-the-minute knowledge about our field accessible in a face-to-face format around the world.
As another note about meetings and expanded international exchanges of information, the date for the INS first interim meeting has been set. In collaboration with the Chinese Neuromodulation Society, the meeting will take place in Chengdu, China, from Aug. 26 – 28, 2016 – less than one year from now!
I look forward to seeing many of you at some of these meetings in the months and weeks to come, and to hearing from even more of you as we seek input on the initiatives and efforts described here. Thank you very much for making my first few months as president of this unique and valuable organization so gratifying. I am sure that as I do, you find motivation for your contributions to the society and your peers from a dedication, first and foremost, to improving the lives of our patients.
Best regards to all,
Timothy Deer, MD
President of INS
International Neuromodulation Society New Committee Structure Starts with 10 Initial Committees
The International Neuromodulation Society (INS) will be instituting a committee structure to further our activities. The INS Executive Board members, with significant input from our volunteer members, have put forward these initial committees:
1. RESEARCH AND SCIENTIFIC OVERSIGHT
This committee will be charged with identifying and vetting research proposals for the INS Research Initiative, along with participating in the INS’s scientific endeavors — such as recommendation development. The committee will also work with the INS Board on important publications and projects to advance the field.
2. FINANCE AND RESOURCE
In collaboration with the INS Executive Officers and Office, this committee will have fiduciary responsibility to develop an investment committee charter and investment plan to ensure the Society’s ongoing financial stability and compliance with accepted standards.
3. INTERIM MEETINGS
In collaboration with the INS Executive Committee, this committee will vet and select future venues of the INS Interim Meetings, and will develop the scientific program with the local organizers.
4. BIENNIAL CONGRESS PROGRAM
In partnership with the INS Executive Committee, Office and Congress Organizer, this committee will vet and select venues of the INS Biennial Congress, enlist section chairs, and participate in the development of the content of the scientific program.
This committee will develop a scholarship or educational program to help individuals in developing countries launch new neuromodulation practices. The program may also help subsidize memberships to provide access to the journal and other membership benefits to those who cannot afford them.
6. PUBLIC EDUCATION, OUTREACH AND WEBSITE
In collaboration with the INS’s Public Education and Website Manager, this committee’s focus will be on neuromodulation outreach and the development of educational material for the INS website and all electronic messaging, including social media.
7. EDUCATION AND CME
In collaboration with the INS Executive Director, this committee will ensure the commercial independence of all of the INS’s educational endeavors, and compliance with ACCME, EACCME and other regional criteria.
8. MEMBERSHIP AND CHAPTER CREATION
This committee will serve as the INS’s ambassadors to recruit new members and assist with the formation of new regional chapters in accordance with the INS’s criteria.
9. INTERNATIONAL WOMEN IN NEUROMODULATION
In collaboration with Women in Neuromodulation in the U.S., this committee will focus on engaging and encouraging women in the field of neuromodulation on a global level.
10. YOUNG NEUROMODULATORS
This committee will engage and serve as mentors to those who are new to neuromodulation to nurture the future of the field.
With international member involvement, we will ensure that all regional interests are well and fairly represented. We asked volunteers to send their first and second committee preferences by the 15th of October. We will do our best to assign volunteers to their requested committees, and will soon be in touch with more details regarding their specific involvement.
Audio and Selected Slides from the International Neuromodulation Society 12th World Congress are Now Available for Members to Download
Select audio recordings and slide presentations from the International Neuromodulation Society (INS) 12th World Congress are available for members to download from the Members Only section of the INS website.
You may log in to see links to audio files and/or PDFs next to entries in the congress program for presentations that have downloadable material available.
International Neuromodulation Society Posts Videos of Montreal Public Event to YouTube
The International Neuromodulation Society (INS) and Canadian Neuromodulation Society presented a free public event prior to the INS 12th World Congress in Montreal, featuring talks by patients and physicians who are members of the INS regarding neuromodulation for pain, bladder dysfunction and movement disorder. Now, videos of those talks have been posted to the INS YouTube channel.
Abstracts from the 12th World Congress are Now Available Online
Abstracts from the International Neuromodulation Society (INS) 12th World Congress have been published in the online edition of the August 2015 issue of Neuromodulation: Technology at the Neural Interface. Please see: http://onlinelibrary.wiley.com/doi/10.1111/ner.12333/abstract.
1st Interim Meeting in Collaboration with the Chinese Neuromodulation Society is Scheduled in Chengdu, China*
For the first time, the International Neuromodulation Society (INS) is holding an interim meeting between its biennial congress. The 2016 meeting is being organized in collaboration with the Chinese Neuromodulation Society. The meeting takes place Aug. 26 – 28, 2016 in Chengdu, China. The contact email is: firstname.lastname@example.org. (*Please note, in November the date was pushed back by one week to Aug. 26 – 28, 2016.)
Three Chapters Hold a Joint Annual Scientific Meeting in London Nov. 6 – 8, 2015
The Neuromodulation Society of the United Kingdom and Ireland (NSUKI) is holding a joint Annual Scientific Meeting on Nov. 6 – 8, 2015 with the German and Swiss neuromodulation societies.
King's College London Strand Campus
Nov. 6 – 8, 2015
Registration and information: http://nsukiasm2015.blogspot.co.uk/p/online-registation-page.html
The meeting includes a satellite meeting of the Interventional Pain Medicine Special Interest Group of the British Pain Society (BPS IPM SIG).
The joint annual meeting topics will include:
- Thirty-Five Years of Neuromodulation
- Neuromodulation and Mechanisms of Action
- Neurostimulation for Phantom Limb Pain
- Burst and High Frequency Stimulation in Failed Back Surgery Syndrome
- Neuromodulation for Headache Disorders
- Sphenopalatine Ganglion Stimulation for Cluster Headache
- High Density Stimulation
- Imaging and Placebo
- Industry Research and Bias
- Spinal Cord Stimulation
- Peripheral Neuromodulation
- Intrathecal Drug Delivery
- Non-Invasive Stimulation
- Fibromyalgia and Emerging Treatments
- Wireless Stimulation
- NSUKI Research RASCAL Study
- New Start Up Neurostimulation Technologies
- Deep Brain Stimulation for Pain
- Deep Brain Stimulation for Huntington’s Chorea
- Deep Brain Stimulation for Tourette’s Syndrome
- Deep Brain Stimulation under General Anesthesia?
- Deep Brain Stimulation Electrode Placement
- Psychological Screening for Neuromodulation
Please see the meeting website for additional information, including topics from the satellite meeting of the BPS IPM SIG.
North American Neuromodulation Society Annual Meeting Dec. 10 – 13, 2015
The 19th Annual Meeting of the North American Neuromodulation Society (NANS) takes place Dec. 10 – 13, 2015, at the Mandalay Bay Convention Center in Las Vegas.
Concurrent scientific sessions, invited lectures, exhibits, posters, and oral abstracts will all feature the range of neuromodulation therapies. Topics range from peripheral nerve stimulation, brain stimulation, best clinical practices, neurorehabilitation and targeted drug delivery to neuromodulation practice issues and current or emerging indications for gastrointestinal or genitourinary conditions.
Among the many offerings, there will be a Certificate of Attendance Course during the pre-meeting on Dec. 10, for 25 pain physicians who wish to formalize providing neuromodulation services. The course’s five instructors will provide hands on-training in surgical techniques and effective and appropriate use of spinal cord stimulators and intrathecal drug delivery systems. In addition to the five-hour cadaver lab, the course includes didactic lectures about key concepts important to incorporating these pain therapies into a medical practice.
Applications for the course are due Nov. 16, 2015, and will be screened by the course directors, Steven Falowski, MD, Jason Pope, MD, and David Provenzano, MD. Applicants must possess, or be able to obtain, privileges for implantable therapies in a Joint Commission-accredited hospital setting, a properly certified surgical center, or a similar facility. Applicants must also have either successfully completed an accredited fellowship in pain management, or an accredited residency in neurosurgery. For more details, see: http://www.neuromodulation.org/Meetings/2015Meeting.aspx
The pre-meeting day on Dec. 10 also includes:
- A cadaver course for residents and fellows, with an enhanced concurrent portion solely for neurology residents
- Hands-on training in neuromodulation therapies for various urologic disorders
- A workshop for beginning and advanced providers of intrathecal therapy, as well as pharmacists and hospital administrators, involving in-depth presentations, smaller group discussions, and case studies
- A midlevel practitioner workshop for nurses and physician assistants, which includes an optional hands-on training in pump refilling
Other special offerings include:
- A new job fair for residents and fellows and other early-career practitioners
- Separate receptions for the Women in Neuromodulation Special Interest Group and the NANS Foundation.
The Inception of the International Neuromodulation Society: From Idea to Successful Organization
From Ablation to Modulation
Following the successful effects of spinal cord stimulation for control of motor disorders in hundreds of patients, reported by J. M. Waltz, MD et al in 1981 (1), a small group of Dutch neuroscientists (neurosurgeons Nanno Lambooy, MD; Michiel Staal, MD, PhD; and neurologist Hans Speelman, MD) realized, when confronted with patients with severe spasms, that this new therapy may be worth considering as an alternative to neurosurgical ablation. So, when this group was discussing the Waltz evidence at a meeting, they decided to try to repeat the favorable reported results. In these early days progress in health care was often made through trial and a lot of error. So, when replicating Waltz findings, the group frequently met with failures and furthermore, the neurosurgeons judged it impossible to predict the outcomes. However, in some patients muscle spasm could very well be treated with neuromodulation.
Scientific ‘Merits’ Granted
In the wake of the initial attempts, neuromodulation got a great boost when the Dutch government honored Prof. dr. Michiel Staal, neurosurgeon at the University Hospital of Groningen, in 1985, with a grant of 750.000 guilders (equals about $300,000), to evaluate which symptoms and diseases are worth to take into consideration for treatment with neuromodulation. The grant enabled him and the group members to study different indications (2). The observational study results showed that angina was one of the most successful. In parallel with the local developments, the Dutch neurosurgeons began sharing their experiences at meetings with anesthesiologists (Maurice Wicks, MD and Elmar Delhaas, MD). The latter group introduced pain as an option for neuromodulation. In addition, neuromodulation indications were further expanded when physicians involved in other disciplines, such as vascular surgery (Michael J. H. M. Jacobs, MD) and cardiology (Mike DeJongste, MD, PhD), started to use neuromodulation to treat patients with refractory ischemic pain syndromes. Given the favorable outcomes of neuromodulation as an adjunct therapy for an increasing variety of ailments, it was decided to organize an international congress.
Furthermore, in parallel with both national and international developments, Peter Theuvenet, MD, PhD, anesthesiologist, and Geert Spincemaille, MD, PhD, neurosurgeon, developed quality standards for neuromodulation, embedded in a quality system, to acquire reimbursement for the different neuropathic pain indications in the Netherlands. (3)
Also, interest was growing to unravel underlying mechanisms of action of neuromodulation. To understand what was going on at the dorsal spinal level when stimulation took place, Prof. Jan Holsheimer, PhD was very successful at the University of Twente in building simulation computer models, and so provided insight into the mechanisms.
The First International Congress on Neuromodulation
Given all these developments enthusiasm was growing to organize a meeting. Therefore, a foundation was established that was coined CORUST (Congres RUggenmerg STimulatie = Congress on Spinal Cord Stimulation). Members appointed to the board were J.C. Sier, MD, vascular surgeon (chairman); Hans Speelman, MD, neurologist (secretary); Michiel Staal, MD, PhD, neurosurgeon (treasurer); Nanno Lambooy, MD, neurosurgeon; Bram Ongerboer de Visser, MD, neurologist; and Lo Bour, PhD, neurophysiologist (Figure 1).
And so during the first three days of June in 1989 the first International Congress on Epidural Spinal Cord Stimulation (ICESS) in movement and vascular disorders was organized in Groningen, the Netherlands (Figures 2 - 3). After this first successful meeting international experts were asked to join the board. As a result an organizing committee was instituted. And in addition to Drs. Staal and Sier, Lee S. Illis, MD, neurologist, London, UK, Daniel Galley, MD, cardiologist, Toulouse, France, Jürg-Ulrich Krainick, MD, neurosurgeon, Homburg, Germany and Mario Meglio, MD, neurosurgeon from Rome, Italy, organized the first INS congress in Rome, in May 1992. The congress was held a year after the conception of the INS in Paris, France in 1991 and the institution of the bylaws in Groningen, two years after the ICESS meeting (Figures 4 - 5). Of note, first Houston, Texas USA was proposed, however, cancelled as the place for the 1st INS congress, “due to lack of support by the Americans”! (As shown in Figures 6 - 7, the canceled plans were listed in the founders’ 1990 meeting minutes, in item VI.)
Mike JL DeJongste, MD, PhD
Chairman, Benelux Neuromodulation Society
Past Secretary (1989 – 1994), International Neuromodulation Society
Past Treasurer (1994 – 1997), International Neuromodulation Society
Michiel Staal, MD, PhD
Past Chairman (2009 – 2014), Benelux Neuromodulation Society
1. Waltz JM, Reynolds LO, Riklan M. Multi-lead spinal cord stimulation for control of motor disorders. Appl Neurophysiol. 1981;44(4):244-57. PubMed PMID: 6978682.
2. Werkgroep Neuromodulatie, http://www.imsn.nl/neuromod eng/html/protocols.html.
3. Theuvenet, P. J., Dekkers, M. A., Beersen, N., Klazinga, N. S. and Spincemaille, G. H. J. J. (2005), The Development of a Quality System for Neuromodulation in the Netherlands. Neuromodulation: Technology at the Neural Interface, 8: 28–35. doi: 10.1111/j.1094-7159.2005.05217.x.
Figure 1: from left to right: Hans Sier, Lo Bour, Nanno Lambooy, Hans Speelman, Bram Ongerboer de Visser and Michiel Staal
Above: Section VI from the minutes from the April 1, 1990 founders’ meeting in Paris
See the supplement for more images of materials from these early meetings.
International Neuromodulation Society Board Updates Conflict of Interest Policy
The International Neuromodulation Society (INS) board ratified an updated conflict of interest policy in June, as part of the INS Board Members’ ongoing efforts to remain transparent about their Industry relations and any real or perceived conflicts of interest. The amendments also discourage the use of the INS’s name and office for any commercial interest’s / company’s benefit. If an organization wishes to obtain the INS’s official endorsement, they should submit a formal request to the Executive Office for consideration.
Due to the INS’s important relationship with a variety of stakeholders involved in developing, supporting, and providing information about cost-effective treatment options in the neuromodulation field, it is incumbent on us to maintain transparency and credibility as an impartial and objective body.
Toward that end, society members who are involved in organizing and implementing INS activities, including but not limited to those filling board and committee positions, must disclose any financial relationship valued at more the $500.00.
Please see the revised policy, posted on the INS website, to learn about the applicable processes involved in maintaining this standard.
WIKISTIM Enters Its Third Year
WIKISTIM, a searchable website of published primary research data concerning neuromodulation, completed its second year of operation at the beginning of October.
WIKISTIM was developed by the nonprofit Neuromodulation Foundation, Inc. (an independent organization from the International Neuromodulation Society), as a resource for the global neuromodulation community, to extend the utility of published clinical research.
It started in 2013 with 500 citations about spinal cord stimulation. The site now has six sections on different stimulation targets – with more sections planned – and contains more than 4,000 citations.
Contributors may list and extract primary research data for tabular downloads. The WIKISTIM October newsletter describes some future goals and enhancements. You are welcome to pass along the link to inform others about this resource: http://www.wikistim.org/wp-content/uploads/2015/10/WIKISTIM-Newsletter-24.pdf.
Table of Contents
Members May Download Selected Congress Recordings, Slides
Public Event Talks
12th World Congress Abstracts are Online
Interim Meeting Date Set for August 2016
Joint Meeting in London in November
NANS Annual Scientific Meeting in December
The Inception of the INS - Looking Back After 25 Years
Updated Conflict-of-Interest Policy
WIKISTIM Enters Its Third Year
Calendar of Events
Indexed! Increase of Impact Factor,
Members may log in to the members-only section’s Global Discussion Forum to participate; watch for updates on our Expert Panels announcement page.