A Message from the President
Dear all INS members,
The INS is a global society and as President I hope that those of you in the Northern Hemisphere are having as good a summer as we are in UK and those in the South I hope your winters are not too severe and you have a chance to enjoy your winter traditions.
The global nature of our society was epitomized by the country of origin of our attendees at INS Berlin 2013. Forty-six countries were represented with over 1,260 registrations; 51 from South America, 307 from USA, 15 from Canada, 22 from Australasia, 763 from Europe, 45 from Asia, 7 from South Africa, 38 from Turkey, 14 from Middle East and 9 others not yet determined!
This was another great meeting for the INS, one at which we were able to attract some of the best plenary speaker talent in our field. Many who before had sat outside the INS were referring to the INS as “our society”. I am hopeful that our new members will play an increasingly important role within our society. Our aim is to nurture this field of medicine and scientific interest and to promote it to all who will listen. By being together we can create the necessary commotion that seems to be required in order to achieve greater access to neuromodulation for our patients that need it. We are glad that you are joining us on this mission.
We had more abstract submissions than ever before (341 received, 304 accepted), with more oral presentations (120). The quality of abstract submissions continues to improve. Our breakout sessions were well attended and I hope that this will continue to reflect and attract the many disciplines involved with neuromodulation.
All the accepted abstracts are to be published in the online version of Neuromodulation: Technology at the Neural Interface, Volume 16, Number 5.
For those lectures that we had permission to record, they will be available to listen to within the members’ section of the INS website
Shortly you will be receiving a survey designed to determine what you regard as important to have in our future meetings. It is important to us to keep improving the meeting to better meet your needs. Thank you in advance for completing this.
During the meeting I met with representatives of five more country or regional chapters in formation. I hope that by the time we all meet again in Montreal in June 2015 these five will have completed the necessary tasks in order to be recognised as an INS chapter.
Your Full Board met in Berlin at the end of the conference and amongst other matters voted to pursue two important initiatives. The first is to create an endorsement policy for the INS, which may in time evolve into a credentialing service. The INS is often asked to endorse surveys, projects, meetings, trainings etc. To date we have been reluctant to do so until we have a policy with established criteria although we need to take care with some of the potential legal and liability issues that may arise. The Executive Board will be working on this and will present to the Full Board for approval in 2014.
The second initiative is for the INS to raise money to benefit research projects upon application and merit. We will never raise enough money to generate a research fund, which would mean many millions to generate income, but we are hopeful that we can attract smaller grants that we may award and administer. The INS is a credible independent voice for neuromodulation and we believe that grant donors will see an advantage in this initiative to foster independent clinical science perhaps supporting work on mechanisms of neuromodulation and clinical studies that require an improvement in evidence base.
Under the leadership of INS President-Elect Tim Deer, the Neuromodulation Appropriate Consensus Conference (NACC) is making good progress. This is an evolving project that will be revised as the years progress but we have to start somewhere. Just look at the benefits that the Polyanalgesic Consensus Conference (PACC) has brought to the field of intrathecal drug delivery. Having reviewed the established country and society guidelines from around the world it is important that our organisation makes a statement on the current science and art of neuromodulation today.
Many of you have told me how impressed you are with our journal Neuromodulation: Technology at the Neural Interface. Editor-in-Chief, Dr. Robert Levy, has of course been the driving force, helped by the editorial staff, Section Editors and Editorial Board. Dr. Levy has further plans for the journal with the aim of taking it to the next level of quality. The Impact Factor continues to rise and, by 2015, we hope that you will see a jump in Impact Factor as the benefits of having our journal Medline-indexed will start to take effect in the published figures. There are several achievements over the last year including a return to profitability (after a couple of years of financial support from the INS), streamlining of time from submission to first decision, increasing from four to six and soon eight editions per year and still maintaining a healthy rejection rate of 48%. These are all markers of a higher quality journal. So please submit your best articles to our journal.
The INS website continues to grow in functionality. I am very pleased with the Discussion Forums, which have benefited from team effort led by website manager Ms. Nancy Garcia, INS Secretary Dr. Marc Russo and I. We have tried to choose INS experts in the field to moderate and to link the discussion with upcoming journal content. The postings are being archived. I encourage you all to participate, although I realize that many like to just read. For those that want a more rapid response to general postings there is the opportunity to join the INS Google group.
We are carefully monitoring the data by which we measure the viewings of our website and it is clear that it has grown by over 100% since last year. If you type in “neuromodulation” into your search engine, in many parts of the world you will see that we now come second to Wikipedia with the journal third. This dynamic ranking has been carefully managed by the website manager, Ms. Nancy Garcia, and the website contributor team who have contributed fresh and useful content.
Leading up to INS Berlin we carefully selected potential content, both abstract and formal presentation, that we thought would be newsworthy and created a number of press releases. We were most heartened by the responses to these as measured by distribution and the appearance of a number of medical journalists at our meeting representing Science, Nature, Trends in Medicine, and other publications. Coverage of our society and neuromodulation appeared in Nature Medicine, the syndicated news service HealthDay, Healthline News (syndicated by Yahoo! Health and Google Health), NeuroNews, Science Daily, major business publications, online services, the German news media, and regional outlets such as WTAE Pittsburgh.
The aim of our website is to serve the membership, your referrers, your patients and the wider investor and research journalist community. I believe we are achieving this in all four areas. We hope to stay current as we move forward.
This project continues and we are grateful to the unrestricted grants that we have received from industry partners in making this possible.
We are currently doing our due diligence work on selecting the INS venue for 2017. The Full Board has voted upon their top five sites out of a possible 12 selected. We always want to prepare well ahead so that you can plan your future research and submissions. Although this exposes INS to financial risk, as we have to pay for deposits for two meetings in advance, we believe this is a risk worth taking, to ensure that we attract the best.
Work on the INS 2015 programme is already underway. As your President since 2009 I have been scientific chair of two INS meetings, London and Berlin. I am passing that honour and task onto Dr. Tim Deer, our President-Elect, for the Montreal meeting (June 2015), although Tim has asked me to be involved as co-chair. We have had preliminary discussions with the Canadian Neuromodulation Society and together we will come up with a great programme.
I shall be concentrating more on INS President issues, as not unsurprisingly there is more work to do. The Executive Board includes Dr. Russo, our Secretary, Dr. Fabian Piedimonte, our Treasurer, Dr. Deer, our President-Elect, and Dr. Levy, our Editor-in-Chief. These colleagues have given their time and wisdom to the INS. I am extremely grateful to them in helping to share this responsibility as we continue to expand and influence. I am also grateful to our four Directors at Large, Dr. Jaimie Henderson, Dr. Konstantin Slavin, Professor Eric Buchser and Dr. Elliot Krames. Elliot Krames was given the prestigious “INS Giant of Neuromodulation” award at this year’s congress in Berlin. The others continue to work on our behalf on INS governance projects, chapter recruitment and education projects.
It is important to recognise the efforts and achievements of the INS staff led by Ms. Tia Sofatzis with Ms. Nancy Garcia and Mrs. Pudy Punsalan, as well as of the congress planning and implementation team led by Ms. Annika Hayes who was assisted by Mr. Ryan Hessels and Ms. Chenoa Sloss. From a very compact and well-organised team great value is being achieved.
Finally we also have to thank and congratulate the Editorial Assistant, Ms. Mary Bockman who now works full time for the Editorial Office and has recently married. Congratulations!
Dr. Simon Thomson, MBBS, FFPMRCA
President of INS
11th World Congress Attracted a Broad, Large Group of Delegates
The geographic distribution of attendees at the 11th World Congress in June is shown in the diagram below, with details of the attendance by country in the table that follows.
|Attending the 11th World Congress
At the 11th World Congress in Berlin in June, there were a full 1,262 registrants from 46 countries, which represents escalating attendance compared to the 1,050 attendees at the congress in London in 2011. The most recent congress had 97 faculty members, 304 poster presentations, and 120 oral abstracts.
The oral and poster abstracts will be published online in our journal Neuromodulation: Technology at the Neural Interface in Volume 16, Number 5, with the following digital identifiers:
Meanwhile, the 12th World Congress will take place from June 6 – 11, 2015 at the Fairmont Queen Elizabeth Hotel. The early-bird registration deadline is Nov. 15, 2014, and abstract deadline is Jan. 12, 2015. Stay tuned for more details.
Many thanks to everyone who made the 11th World Congress a success, and we look forward to seeing you in Montreal in 2015!
Members May Download and Listen to Audio Files from the 11th World Congress
Selected presentations about neuromodulation from the 11th World Congress are posted for members in the Members Only Section - Previous Congress Proceedings link.
Meanwhile, images from the congress are posted on the INS Facebook page, where members are welcome to add more.
Faculty and other audience members listen to the 2013 Congress.
On the aisle at the front right is Dr. Sam Eldabe, president of the Neuromodulation
Society of the UK and Ireland; next to him is Director-at-Large Dr. Eric Buchser of the
Switzerland chapter, with other speakers and faculty members..
Neuromodulation Appropriateness Consensus Committee Announces First Neurostimulation Guidelines
At the start of the International Neuromodulation Society's 11th World Congress in June, the Neuromodulation Appropriateness Consensus Committee announced it has created the first consensus guidelines for the use of neurostimulation in pain and other disorders. The guidelines are based on clinical studies, case reports, and expert opinion in this rapidly advancing area of "digital drugs," and are expected to help lower the need for opioid use to control chronic pain -- and its associated problems, said committee leader and International Neuromodulation Society President-Elect Tim Deer, MD. With more than 60 co-authors, the guidelines are being submitted for peer-review publication Neuromodulation: Technology at the Neural Interface.
The Provincial Program of Neuromodulation of the Province of Buenos Aires (PPNM)
Director: Juan Carlos M. Andreani, MD
Vice-Director: Dr. Fabiàn Piedimonte, MD
1st Secretary: Dr. Guillermo Larrarte, MD
2d Secretary: Dr. Miriam Sànchez Crende, MD
3rd Secretary: Dr. Patricia Nucitelli, MD
Neuromodulation techniques are increasingly employed worldwide but in spite of their undeniable benefits, their indications are not completely outlined and are evolving. For this reason, for optimal results, sufficiently trained professionals are needed to perform or indicate their use.
With this in mind, in the province of Buenos Aires, Argentina, the Provincial Program of Neuromodulation (PPNM) was organized two years ago with the objective of supervising indications for neuromodulation, optimizing results and increasing cost-effectiveness by organizing and training professional staff.
The PPNM is a governmental organization under the Ministry of Public Health of the Province of Buenos Aires, which comprises 15.3 million people in a region of 307.5 square kilometers. Different centers that provide rehabilitation, neurological treatment, and pain management work in association through the PPNM, which is directed by qualified professionals in neuromodulation. Within this structure, patients are selected, operated on, and followed up.
The intent is to open a PPNM branch in each of 12 health districts, under central PPNM supervision, in order to contain costs and facilitate follow-up.
The PPNM has been created to optimize results of neuromodulation techniques and improve patient care by multicenter and multidisciplinary management of experts.
Neuromodulation techniques require expertise and their costs are high whenever this technology is required, hence careful selection of patients and training for healthcare teams are essential.
The experience obtained through the PPNM will be shared with the International Neuromodulation Society (INS) in order to help to inform and guide approaches in other places.
We believe the PPNM is useful to guarantee the maximal benefits of neuromodulation techniques in public health.
The PPNM has been presented at the past two INS world congresses, in London in 2011 and in Berlin in 2013, and can be described as an institution to promote, teach and supervise indications for neuromodulation techniques to improve their cost-effectiveness and to guarantee long-term continuous improvement and access to up-to-date methods.
Our objective in this report is to make the program known to the International Neuromodulation Society community and to show our first two years of activity in the area.
Our first issue was to orient our activity with respect to practices elsewhere, so we gathered information during attendance at INS meetings, and we also took guidelines from other critical branches of medicine, and tried to adapt them in order to manage this governmental agency for neuromodulation.
We took advantage of the complexity of some medical specialties such as cardiac surgery and other critical care issues, such as organ transplantation, which require external oversight in order to be properly managed, thus avoiding failures as much as possible, to achieve at the very beginning a reasonable cost-effectiveness ratio. Neuromodulation techniques have similarities due to requiring advanced technology and highly trained staff, and so need similar organizations to help manage the special characteristics of the activity.
In geographic expansion, our program has opened two centers for surgical activity in different regions of our territory. We are starting a research center, and an agreement with the national government is being evaluated.
During the first two years of our activity in the province of Buenos Aires we handled consultations through mail as well as online. About 300 patients were evaluated and 55 implants were done. Four meetings for specialists and two training courses for nurses and physiotherapists were organized.
Since the very beginning of our existence we have advanced in the objective to treat patients and to guarantee staff development. Still to be accomplished are establishing research programs regarding the main subjects of our discipline, as well as extending our presence to more remote areas of our province.
Dr. Juan Carlos M. Andreani
Director - PPNM
The Polish Neuromodulation Society Becomes the International Neuromodulation Society’s Newest Official Chapter
Just before the 11th World INS Congress in Berlin, the Polish Neuromodulation Society completed the final requirements to become an official INS chapter and has a current tally of 35 paid-up members. The society is looking forward to a long and fruitful cooperation with the international neuromodulation community.
As one of its first official activities as a chapter, the Polish Neuromodulation Society (PTN) was honoured to organise a satellite conference that was held after the INS congress in Warsaw, Poland on 14-16 June 2013. The programme of events included a joint meeting between the Polish Neuromodulation Society and Argentinian Neuromodulation Society (SANE), at Warsaw’s historic Hotel Bristol, next door to the presidential palace, on 14 June 2013. The joint effort included sessions on interventional pain medicine and neuromodulation for pain management and movement disorders from an internationally acclaimed faculty.
The 1st International Symposium on Peripheral Neuromodulation took place at the Royal Castle on 15 June 2013 with an impressive 19 lectures on this topic that day. Dr. Michael Stanton-Hicks, Dr. Elliot Krames, Dr. Robert Levy, Prof. Samer Narouze, Dr. Porter McRoberts, Prof. Turo Nurmikko, Dr. Declan O’Keeffe, Dr. Teodor Goroszeniuk and other leading lights in the field of neuromodulation contributed to the meeting.
The free oral presentations and poster presentations at the conference were popular with contributions from the U.S., Argentina, Brazil, Poland, Slovakia, Latvia and the U.K.
The meetings at the Hotel Bristol and Royal Castle were followed by a well-attended
ultrasound in pain medicine workshop at Staszic Palace, the headquarters of the Polish Academy of Sciences, on 16 June 2013. The first such course in Poland to-date, it included seven hands-on ultrasound scanning stations with live models and phantoms. Expert faculty taught the use of ultrasound for interventional pain relief procedures.
A total of 140 delegates joined us in Warsaw from as many as 20 different countries
including Australia, the U.S., Canada, Argentina, Brazil, the U.K., Ireland, Germany, Austria, Belgium, the Netherlands, Slovakia, Poland, Latvia, Azerbaijan, Jordan, Greece, Spain, Switzerland and Portugal.
Colleagues from the International Neuromodulation Society, the Polish Association for the Study of Pain, the European Federation of IASP Chapters and the London Pain Forum also participated at the conference.
The European Accreditation Council for Continuing Medical Education awarded a total of 17 CME credits for the three-day event.
Meanwhile, PTN is investigating the possibility of organizing a media event later in 2013 to further promote the neuromodulation modality in Poland. In addition to regular international conferences and cadaver workshops the society is also planning a series of smaller Polish language regional meetings in collaboration with various neuromodulation centres around Poland.
Dr. med. Wiesław Łach
Secretary of Polish Neuromodulation Society
Contacts for Neuromodulation Society Chapters in Formation
If you or colleagues may be interested in one of the International Neuromodulation Society chapters in formation, contact information is provided below for a number of these.
Abdullah Alghamd, MD, FRCPC
KING FAISAL SPECIALIST HOSPITAL
RIYADH, Saudi Arabia
Kaare Meier, MD, PhD / læge, ph.d.
Aarhus University Hospital
Jamil Rzaev, MD, PhD
Federal Neurosurgical Center
Please stay tuned for more details
Non-invasive Stimulation for Pain; Pros and Cons of Paddle Leads vs. Percutaneous are Topics of Next Two Expert Panels
Two Expert Panels are planned to begin in October 2013. Both interactive, moderated discussions take place in the Members Only Section of the INS website, www.neuromodulation.com.
The first panel in October concerns repetitive transcranial magnetic stimulation for neuropathic pain. Prof. Turo Nurmikko, MD, PhD, professor in Pain Relief, The Walton Centre NHS Foundation Trust, and director of the Pain Research Institute, will moderate the session from Tuesday, Oct. 8 through Tuesday Oct. 22, 2013. Prof. Nurmikko leads a number of studies involving the role of transcranial magnetic and transcranial direct current stimulation of the brain in chronic pain. Using functional and structural brain imaging, non-invasive brain stimulation, quantitative sensory testing, electrophysiology and other methods, he is exploring peripheral and central mechanisms of chronic and experimental pain.
The next panel coincides with publication in Neuromodulation: Technology at the Neural Interface of a research paper by Shivanand P. Lad MD, PhD and colleagues, “Outcomes of Percutaneous and Paddle Lead Implantation for Spinal Cord Stimulation: A Comparative Analysis of Complications, Reoperation Rates, and Health-Care Costs”. The panel will examine comparative pros and cons of percutaneous or paddle leads for spinal cord stimulation (SCS).
In the panel from Oct. 27 – Nov. 10, 2013, INS President Simon Thomson, MBBS, FRCA, FIPP, will advocate advantages of percutaneous leads, and INS Director-at-Large Konstantin Slavin, MD, will advocate the pros of paddle leads.
Dr. Thomson has been using SCS for 21 years. A consultant in Anaesthesia and Pain Management services at Basildon and Thurrock University NHS Trust, he has only personal experience at placing cylindrical placed leads. He has been involved in research, guideline writing, training, teaching and clinical audit, and has a keen interest in spinal cord stimulation becoming a standard of practice for the management of refractory neuropathic, ischaemic and visceral pain. Indeed his efforts have been to ensure that there is high quality clinical evidence for the effectiveness and safety of this useful therapy at an affordable cost.
“SCS has its origins with neurosurgery with open placed leads (paddles)," he noted in preparing for the panel, "but like with many other surgical techniques the drive is towards minimal intervention. The supposed advantages of paddle leads are being matched by cylindrical leads (percutaneous), multi-contact platforms, better anchors and robust leads. However the increased risk of major neurological harm, in-patient stay and patient morbidity relegates paddle lead placement to a secondary procedure if cylindrical lead therapy fails. At the very least patients should be fully informed that there is an alternative with a different risk/benefit profile.”
Meanwhile, Dr. Slavin serves as professor of neurosurgery in the University of Illinois at Chicago and has treated hundreds of patients using SCS over the past 15 years. Among other publications, he co-authored “NANS Training Requirements for Spinal Cord Stimulation Devices: Selection, Implantation, and Follow-up” in Neuromodulation in 2009 and a recent paper on “Incidence and avoidance of neurologic complications with paddle type spinal cord stimulation leads”, published in Neuromodulation: Technology at the Neural Interface in 2011. Dr. Slavin has been selected to co-host this discussion because of his expertise in both percutaneous and laminectomy-type SCS electrodes.
New Patient Handout Offers Overview of Cancer Pain and Neuromodulation Option
International Neuromodulation Society member and congress faculty member Lisa Stearns, MD, of the Center for Pain and Supportive Care in Phoenix, AZ has created the latest fact sheet for the International Neuromodulation Society regarding how the practice of pain medicine can reduce the burden of cancer-related pain, improving overall wellness and resiliency. Her handout can be printed as a PDF or emailed as a link to patients. As with all INS patient-education handouts, a version is available in the Members Only Section that allows practitioners to add their contact information in the bottom margin.
Job Board Serves Members Who Are Offering or Seeking Employment
A new member benefit is a Neuromodulation Job Board available to members who are seeking employment or fellowships, or who wish to post opportunities to recruit fellows or employees, which can be done by filling out the online form. The Job Board is free to members to post openings or view opportunities, and can be found in the Members Only Section of our site, www.neuromodulation.com.
International Neuromodulation Society Receives New Public Education Grants
The International Neuromodulation Society is thankful for continued, and new, support of its Public Education Program in 2013 from Medtronic, Inc., St. Jude Medical Foundation, Boston Scientific Corporation and (new funder) Nevro Corp. As the field continues to expand and mature, much has been accomplished by the INS to increase awareness and visibility among various audiences to help encourage referrals, access to training, clinical trial recruitment and patient-care opportunities, and the need continues. The unrestricted funding allows the society to perpetuate its activities in spreading noncommercial, objective, and balanced information about this evolving families of therapies to advance scientific understanding and medical practice.