 
Neuromodulation News: January 2017
President's Message l Pelvic Pain Online Panel Starts This Month l Chapter News from 2016
 A Message from the President
To the Neuromodulation Community:
It is a landmark time as we reach the 50th anniversary of the publication of the first experience of neurostimulation by C. Norman Shealy, MD, PhD who first demonstrated relief of chronic pain through spinal cord stimulation. After this first communication, the growth of the therapy was anticipated to exceed 50,000 implantable pulse generators by 2014, and has continued to grow. The number of people helped by these options has been staggering and gratifying for those of us who have spent our careers dedicated to improving disease states and quality of life.
Although spinal cord stimulation comprises about 80% of the market for implanted neuromodulation devices, deep brain stimulation to treat the motor symptoms of movement disorder paralleled a similar development time frame. This success was followed by motor cortex stimulation, peripheral nerve stimulation, and amazing innovations such as cochlear nerve stimulation for hearing enhancement and sacral nerve stimulation for urinary and fecal incontinence.
The progress has generated investigation into potential new targets and indications; a review of deep brain stimulation in 2013 listed 40 different brain sites for at least 30 clinical indications.
As this progress has unfolded, the International Neuromodulation Society has been at the forefront of research and clinical practice; this month, comprehensive guidelines concerning neurostimulation and intrathecal drug delivery appeared in Early View in our journal, Neuromodulation: Technology at the Neural Interface. An international team of authors, convened by the INS Executive Board, authored these six peer-review articles that – in the words of one reviewer – should serve as a gold standard for practitioners and others interested in the field.
This is the fifth iteration of guidance since 2000 that was produced about intrathecal drug delivery (ITDD) by members of the Polyanalgesic Consensus Conference (PACC). The authors systematically evaluated and rated evidence published in the scientific literature by 2014. They note that approximately 80% of the use of ITDD systems in the U.S. is “off-label” and discuss aspects of the therapeutic agents used. As they note, these agents often undergo some degree of compounding for dilution or similar preparation, and the use of admixtures pose some particular considerations. The new PACC guidelines give insights into the most efficacious and safety based options for the pain practitioner.
Meanwhile, the Neuromodulation Appropriateness Consensus Committee (NACC) has updated its original 2014 guidance in a new set of three documents. In keeping with the practical nature of the guidelines, the articles address patient-care issues concerning bleeding and coagulation management, infection prevention and management, and the reduction of severe neurological injury – concerns present with any surgical procedure involving neurological areas.
With the expansion of ways to therapeutically stimulate neurological targets, the Executive Board has slightly updated the official INS definition of neuromodulation to not limit the definition to electrical stimulation or chemical agents; an introduction on our newly redesigned homepage now describes the therapy as: “the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body.”
In addition, both less-invasive and non-invasive stimulation methods will be among presentations during our 13th World Congress preconference on May 27, 2017. The next day, May 28, emerging companies will present at the second preconference, “Innovations in Neuromodulation”.
The 3.5 day-scientific program covers the full scope of neuromodulation therapies. For instance, esteemed faculty will present the latest developments in brain stimulation, dorsal root ganglion stimulation, and cervical spinal cord stimulation.
During the third full day of the congress on Wednesday, May 31, we will have the special honor of recognizing our 4th Giant of Neuromodulation. Dr. Michael Stanton-Hicks was unanimously selected by the Executive Board for this honor due to his longstanding and pioneering contributions to the development of neurostimulation for chronic pain, and the nomenclature and treatment of a leading indication for spinal cord stimulation – complex regional pain syndrome.
If you have not already done so, I urge you to make arrangements to attend the congress in Edinburgh, Scotland, from May 27 to June 1, 2017. The scientific program is nearing completion and will be shared soon. I congratulate the INS Executive Board, Biennial Congress Committee, Education and CME Committee, and the local organizers from the Neuromodulation Society of the United Kingdom and Ireland, and all who are making this event a success.
Important dates for the 2017 congress are:
As I mentioned in a recent email, I am personally very excited to share with you that the Edinburgh Marathon Festival is taking place immediately preceding our main congress on Sunday, the 28th of May. Drs. Chris Kim and Michael Saulino stepped up to co-lead a "Team INS Edinburgh 2017". Note: Runners will miss out on the excellent pre-conference session, Innovations in Neuromodulation, as the events are happening concurrently.
In closing, I wish everyone a successful and happy New Year.
Timothy Deer, MD
President of INS
Expert Panel on Pelvic Pain and Neuromodulation, Jan. 23 - Feb. 6, 2017
The most recent INS Expert Panel in November drew participants from nine countries and nearly 500 views. We hope you will make time to participate in, or view, the upcoming session.
From Monday, Jan. 23 through Monday, Feb. 6, 2017, International Neuromodulation Society Director-at-Large Leonardo Kapural, MD, PhD, will moderate an Expert Panel for members on "Pelvic Pain and Neuromodulation" in the Members-Only Section Global Discussion Forum. There, you can look back at the 14 Expert Panel topic threads dating back to 2012.
About the panel, Dr. Kapural said, "While the anatomical landmarks for utilization of neuromodulation are clear, complexity of chronic pain originating from the pelvis and pelvic floor still present a great therapeutic challenge. Despite the fact that we still do not have evidence-based literature to support steps in the algorithm for treatment of pelvic pain, this panel is assembled to discuss and clarify indications, patient selection, selection of approaches and hardware for chronic pelvic pain neuromodulation. Novel approaches and waveforms will also be discussed."
See more about his background and prior Expert Panels on the Expert Panels page.
A number of ideas are under consideration for future topics, to be offered approximately twice a year, particularly concerning existing or emerging indications.
Chapter News
Argentina l Canada l Colombia l France l Germany l Italy l Japan l Nordic l United Kingdom and Ireland
Argentina Sociedad Argentina de Neuromodulación (SANE)
Dear Colleagues and friends of INS:
We are pleased to inform you about our activities since our last Board meeting. During this period we continue to struggle against the lack of financial support from the industry, government, or other source, and also the national (maybe around the world, too) economic crisis, which limits some of our achievements and make us fall into a vicious circle that we continue to break.
1) Internal relationships:
We are always facing the critical issue of the number of our members, who are 24 at the present time, with 4 possible additional applications. The new electronic system of payment, installed since 2014, has facilitated but not accelerated the regular payment of membership´s fees, which must be continuously supervised, in order keep our number of members into INS acceptable limits. One possible way out to solve this continuous situation, would the payment of a fixed number of memberships, from industry or laboratories, even though we have been continually asking us it has always been denied. Other form, which is ongoing, is to take advantage of some developments through our work with the mostly integrated by non-physician professionals, Instituto Nacional de Tecnología industrial (INTI), where Dr. Andreani is assistant and researcher, and where we are doing some developments. As we have signed an agreement for cooperation with them on 2015, we are trying to integrate those kinds of professionals to our circle. Nevertheless, it is very difficult to convince to pay such a memberships to people without link to medical profession, that´s why the lack of industry or laboratories´ help is twofold harmful. Nevertheless, the limited number of professionals facing neuromodulative activities continues to be an upper limit for recruitment. We continue to provide assistance and feedback, with our members into the west of our country, provinces of Mendoza and San Juan, through patient´s medical care and informal symposia.
2) Institutional relationships:
As we finally obtained our governmental recognition as a nonprofit organization so, we have signed an inter-institutional agreement with the INTI (Instituto Nacional de Tecnología Industrial), the governmental technological organization, in order to cooperate with technical help. We already had a pre–agreement signed in 2011, waiting for our official recognition through our regulatory organisms, and we are currently doing or participating in research and developments, through that entity. We are evaluating another signed cooperation agreement with a private university (Universidad de Moron), to complement this activity for development and research.
3) International relationships:
We had organized and participated on the joint Brazilian – Argentinian meeting (RECOBRAN V), one afternoon 13th May, 2016, in Natal, Brazil, during the XII CONGRESO BRASILEÑO DE ESTEREOTAXÍA Y NEUROCIRUGÍA FUNCIONAL.
4) Scientific activity:
a) We are preparing presentations and posters for the next INS World Congress in Edinburgh 2017 and some of our members are engaged to assist to this event.
b) We have recently published a new paper in Neuromodulation and we are preparing other ones.
c) We have published five papers last year in our revue Neurotarget. Other papers are ongoing.
d) We are currently publishing our review Neurotarget, through a new cycle, in 4 annual issues.
5) Academic activities
a) We have partnered and helped in the organization the Theoretical and Practical Course on Interventional Chronic Pain Treatments of the Federación Latinoamericana de Asociaciones para el estudio del Dolor (FEDELAT) on April 28th, 2016 in Buenos Aires – Argentina, directed by Dr. Fabián Piedimonte.
b) We have organized a roundtable with four conferences at the NeuroPinamar meeting that was on the afternoon of December 1st. The conferences were dictated by Drs. Noemí Rosenfeld, Miguel Zangone, Fabián Piedimonte and Juan Carlos Andreani.
c) We have designed and inscribed a university biannual theoretical and practical course, 80 academic hours, for 2017-2019, approved by the academic council of the Faculty of Medicine – University of Buenos Aires, starting next April 2017.
d) We participated in a National Symposium Pain Meeting in August, in the city of Buenos Aires, Argentina (Noemí Rosenfeld, Fabián Piedimonte and Beatriz Mantesse).
e) A national joint meeting of SANE was held in November - December in Buenos Aires, joining our fellow Brazilian and Colombian societies of the INS, reinforcing our previous commitment to help the development of regional chapters. Colleagues of Chili, Ecuador, Uruguay and other emerging chapters are scheduled, and engaged to participate. We are also evaluating, on the same dates, to schedule the 3rd Polish and Argentinian joint meeting. (The first was in Warsaw - Poland, 2013 and the second in Mendoza - Argentina).
6) Development of Neuromodulation Activities:
We continue to grow the PPNM (Programa Provincial de Neuromodulation) the is directed by some of our senior members and has the support of the government of the Province of Buenos Aires – Argentina. This program is intended to increase access to the technology and rational assistance to the population of that area of our country (more than 15 million people, representing about 40% of our total population), to serve as the basis for a Provincial Law for implants and to afford our experience for the establishment of international guidelines for neuromodulation procedures. We have already evaluated hundreds and treated more than 100 patients, and we have also treated patients living in other regions of our country. We have made 18 periodic reports to the Public Health authorities and we presented the organization at the INS 10th World Congress in London, during the event RECOBRAN II (Brazil and Argentinian Joint meeting 2012) and during the INS 11th World Congress in Berlin, in June, 2013, through institutional posters during each of those events. We had presented a new update for Montreal 2015, which was rejected by the INS reviewer/s.
Notwithstanding, we are insisting to present a new paper about the subject with another institutional update during the INS 13th World Congress in Edinburgh, on June, 2017.
7) The Argentinian and regional community of neuromodulation and functional neurosurgery were eagerly awaiting the possibility to nominate Buenos Aires – Argentina to be the home of some future World Congress of the INS, that could be an important step to enlarge our activities in Argentina and also our region, as it was shown when the world meeting of the International Association for the Study of Pain (IASP) was held in Buenos Aires on October 2014.
With best regards for all the worldwide colleagues, all the best for 2017
Juan Carlos M Andreani President SANE
Fabian Piedimonte Past - President SANE
Miguel Zangone Vice - President SANE
Noemi Rosenfeld Secretary SANE
Juan Pablo Puente Executive Director
Canada
The Canadian Neuromodulation Society (CNS) held its 9th meeting in Oct. 2016 in Regina, Saskatchewan on the 10th anniversary of the founding of the CNS. The location was selected to honor the late founding president Dr. Krishna Kumar, who was a longstanding member of the medical community there. We had the opportunity to honour Dr. Kim Burchield, who gave the Dr. Kumar Lecture and Dr. Ashwini Sharan, who gave the Dr. Tasker Lecture. Numerous international outstanding speakers presented their work and ideas that made this meeting a unique and great success.
At the general meeting, activities in 2015 were reviewed. We noted the close collaboration of the CNS with the INS for the organisation of the 12th INS World Congress in Montreal. We are proud of the great success of this event that had the largest number of attendees of a worldwide neuromodulation meeting.
The CNS organized a public awareness event at the INS congress and invited several international colleagues (Dr. Simon Thomson, Dr. Kaare Meier) to give direct public access to knowledgeable experts in the field of neuromodulation. Although the number of attendees was less than expected, awareness of neuromodulation reached an estimated 600,000 – 800,000 people through the meeting, radio and TV interviews, social media and the INS and CNS websites.
The 1st CNS/INS cadaver workshop that was organized just before the biennial INS congress was great success. The CNS has volunteered to help to organize such activity with the INS and the national chapter for future meetings such as the one in Edinburgh for the 13th INS World Congress.
Members discussed the chapter’s neuromodulation database. Partly due to companies having their own registries, there had been a lack of funding, so the chapter decided to suspend that activity for the moment and encourage centers to continue to collect their data. The possibility of using the Danish database put forward by Dr. Meier and colleagues for spinal cord stimulation for pain was mentioned.
Finally, CNS needed to update its bylaws in order to comply with Industry Canada requirements. Among modifications presented, the number of members needed for a quorum is now 10% rather than 50%, which will make it easier to hold meetings. The CNS bylaws are now in total compliance, and are available on the CNS website.
A new board has been elected:
Dr. Chris Honey, President
Dr. Michel Prud'Homme, Past-President
Dr. Keith MacDougall, Vice-President
Dr. Magdy Hassouna, Secretary
Dr. William McDonald, Treasurer
Dr. Alan Berkman, Member-at-large
Dr. Keith MacDougall, Member-at-large
Russell Munson, Member-at-large
Susan Schellinck, Member-at-large
The Board expressed warm appreciation and thanked sincerely the members who left the board after years of profound dedication. Special thanks were given to Dr. Krishna Kumar our funding president; Louise Malish, nurse, and Ingrid Fedoroff, psychologist, at St Paul Hospital in Vancouver; Andrew Parrent, neurosurgeon in London, Ontario; and past vice-president, Michel Prudhomme, neurosurgeon, who is stepping down as president to become past president.
The CNS will now prepare the next meeting that will be held in Whistler, British Colombia in February or March of 2018.
Finally, all members and board members would like to transmit our sincere best wishes and greetings to the international community for the Holliday seasons and for the year to come. Have a good and productive 2017 year.
Colombia ACIAN – Asociación Colombiana de Intervencionismo Analgésico y Neuromodulación (ACIAN) – INS Chapter
We are a team of specialists train in pain care. Skilled professionals and scientists for the practice and study of Pain Management and Neuromodulation. The principal motivation of our association is to lead good practices, working along with national and international organizations that coincide with our goals.
With our work, we have achieved the accomplishment of the following activities in 2016:
- Regional launch of ACIAN – Pereira, April 2016 – Colombia, participation of 16 specialists of the region and Dr. Carlos Yepes as speaker. Aimed to make known ACIAN as a committed association in the promotion of good practices in the specialty.
- Annual Management Board INS – Edinburgh, July 2016 – Scotland, with the objective of presenting Colombian INS Chapter before the Board of Directors/Management Board and stating the academic proposal for 2017.
- 1st Symposium Pain Management “KNOW PAIN”, International Hospital of Colombia, August 2016 – developed in partnership with the ACCP Asociación Colombiana de Cuidado Paliativo. Intervention in pain management, state of the art.
- Constitutive meeting INS – Sevilla, 20th, 21st and 22nd of October 2016 – Spain, guild event in which the target of promoting ACIAN 2017 congress was accomplished, we assumed the following responsibilities:
1. Strengthen Colombian INS Chapter.
2. Promote, in partnership with Brazil and Argentina, Colombia as host country for the “INTER-MEETING” INS 2018.
3. Convene women specialists in Neuromodulation to become active part of the “WIN-TEAM” board.
4. Organize the first congress of Pain Management and Neuromodulation.
5. Offer continuous medical education. 6. Promote centers of excellence in Neuromodulation.
- We joined Expert Panel on Spasticity and Neuromodulation – INS Global Discussion Forum, participation of Drs. Konstantina Petropoulou and Michael Saulino, that took place from the 1st to the 15th of November 2016 via chat, meeting the objective of expanding the knowledge to strengthen the field of the specialty.
- III Workshop in pain management and palliative care – Medellín, 25th and 26th November 2016. An event for specialists developed together with the ACCP Asociación Colombiana de Cuidado Paliativo and coordinated by Dr. Bilena Margarita Molina. Accomplished the goal of regional launch of ACIAN in Medellín where 21 specialists interested in joining our team are located.
ACIAN civil non-profit association, devoted to promote high quality on the exercise of the specialty in Colombia, promotes the exercise of the specialty’s legislation, benefit of humanity, works along with the INS to build the scientific development of Neuromodulation.
Kind regards,
Luz Elena Cáceres Jerez President ACIAN – INS Colombian Chapter
France
Dear colleagues,
We are happy to share the 2016 French Chapter Report.
General context and objectives
The French Neuromodulation Society has been suffering during the past 10 years from a lack of enthusiasm and engagement due to various reasons. This situation has been very frustrating for the new generation of implanters in France and for the active members of the community. A recent convergence of positive energies all over French regions has made it possible to write a new page of the French INS Chapter. We have now 60 members taking part in this chapter.
Our main goal for the years 2015-2017 has been to attract a panel of new board members and new members in the French community. We put a lot of energy in bridging the gap thanks to a strong collective determination to develop scientific interdisciplinary aspects and robust collaborations before any political consideration.
The year 2016 was rich in scientific events and great discussions, as will be more detailed below. We have now a feeling of “breathing again”. Nothing of this would have been possible without the tremendous support of the INS international board, especially Simon Thomson, Tim Deer and Robert Levy but also Tia Sofatzis who helped us so much. We would like to warmly thank all of them again in this Chapter Report.
The year 2017 will be a decisive year since we need to confirm that this positive feeling is not just a mirage. We therefore built up a dynamic scientific program for 2017 and we will now also invest on political aspects. Indeed, one of the main reasons for French society’s vulnerability comes from the fact that neuromodulation techniques are dramatically under-penetrated in France. Not only in the perception of patients or the public but also in our own pain physician community. Not a single session dedicated to neuromodulation in the last scientific program of the pain society annual congress!
We will have to fight against convictions, to convince our own environment about the need for change. This will be our challenge for the years 2016-2018. But we stay very enthusiastic and confident in the future. Real progress has been made. We must now confirm the attempt!
2016 Scientific Events
1. The 1st SFNM annual national symposium was held in June this year in Poitiers, having as guest Dr. C. Perruchoud, president of the Swiss Neuromodulation Society. The Scientific Meeting program included:
- Update on intrathecal Drug Delivery in cancer pain management
- Novel neuromodulation techniques and waveforms for Complex Regional Pain Syndrome
- Presentation of three new registries which will be launched in France in 2017 under INS supervision: L-TOR, PREGNASTIM and PHYSIOSTIM modules for the follow-up of SCS patients on the long term (L-TOR), during pregnancy (PREGNANSTIM) and before/after physiotherapy as a preconditioning option or an added therapy to SCS (PHYSIOSTIM)
Next steps:
- Modify the set-up of our registry into a non-observational study (a new “Jardé” law on biomedical research involving the human subject was recently voted in France) for regulatory approvals (1st trimester 2017)
- Train the investigator sites with the software, which was developed for these three projects (2nd trimester)
- Initiate the study (3rd trimester)
The French Chapter also held a joint INS meeting with the Swiss Chapter in Montreux on 18th -19th of November during the Swiss Pain Congress, where Professor Rigoard chaired lectures on Intrathecal Therapy, Clinical Research Credibility and Methodology of Guidelines. Dr. Dupoiron had the opportunity to share his IDD-experience with the community. A big thanks to the Swiss interventional pain and neuromodulation societies for their welcome!
3. An SFNM Administrative Office meeting took place in Bordeaux on the 24th- 26th of November at the same time as 2016 Congress of the Société Française d’Etude et de Traitement de la Douleur (SFETD). It primarily involved taking stock of the SFNM 2016 activities and organizing the forthcoming events for 2017, including:
- The next SFNM Symposium, which will be held in Marseille, the 12 and 13th of May 2017. The main topic will be: “Vascular and Metabolic Diseases/Neuromodulation Indications”. We will have the pleasure to welcome Mike De Jongste to share his experience in Cardiac and Vascular indications (These indications are not reimbursed in France anymore for nebulous reasons) in the morning session. The afternoon will be dedicated to peripheral diseases including neuropathies. We will welcome Dr. De Vos from The Netherlands and the last session will be focused on metabolic disorders with potential new DBS indications. We hope to welcome numerous cardiologists, cardiovascular surgeons and endocrinologists at this meeting.
- The next INS meeting in Edinburgh of 27th of May - 1st of June 2017. We hope to present the final results of the French multicenter RCT about multicolumn SCS and Back Pain.
- A new Educational Training in Strasbourg, IRCAD, planned for June 2017. The concept will be to have a mixed panel of anaesthesiologists and surgeons training, hand in hand, the new generation of implanters in France and start to be attractive for the young medical population.
Please also note that:
- We are still waiting for an official answer from our Ministry of Health to an invitation letter we sent in the early beginning of 2016, to keep them updated with this new dynamic process.
- We are glad to support several on-going RCTs and prospective studies in France and take the opportunity to congratulate Dr. Raoul from Nantes since she obtained a national grant in December 2016 from the health ministry to conduct a multicenter RCT about Occipital PNS in Arnold Neuralgia. These data will add a great scientific value to the French Chapter efforts.
With ours best wishes and regards,
President: Prof. Philippe RIGOARD
Treasurer: Dr. Marie-Christine DJIAN
Secretary: Dr. Eric BLONDET
Germany - German Chapter of the INS: Deutsche Gesellschaft für Neuromodulation
Dear friends and colleagues of the INS:
We are pleased to update you about our activities since last year’s joint meeting with Austrian Neuromodulation group and other ongoing activities of the German chapter of the INS.
1) Proceedings:
Our annual meeting took place in Düsseldorf from 11th to 12th of November 2016. The scientific content focused on interdisciplinary collaboration with neurology for the treatment of movement disorders by Deep Brain Stimulation, ENT for SPG stimulation in cluster headache, urology for sacral nerve stimulation in OAB and cardiology with a special focus on SCS for angina. As new techniques are emerging for DBS and SCS, these were the second scientific focus of the meeting. New stimulation paradigms where intensively discussed with local and foreign experts, especially during industry sponsored symposia.
For the first time a hands-on course for neuromodulation nurses was organized as a satellite of the main meeting with an overall positive feedback.
With respect to education, the DGNM has organized a series of workshops and training courses for residents and fellows in cooperation with SJM, started in January 2016. As previously announced, prior to the annual meeting an industry open SCS cadaver workshop took place under the auspices of the DGNM, which was also certified by the DGNM. We are grateful for the generous support of Nevro and SJM, making this course possible.
Regarding logistics of the DGNM itself, we finished the consolidation process of the society by changing the place of the society to Berlin and commissioning a professional company with organization processes. As a visible result of his work, we could increase the number of active members of the German society for neuromodulation to 122.
The multidisciplinary research and collaboration which already was a key aspect of this years´ meeting should and will be one of our main fields of work in the next years. We are therefore actively looking for a professional diversification in the DGNM member structure.
DGNM members largely confirmed the DGNM board members from the previous election: Jan Vesper (MD, PhD) Düsseldorf, president, Wilhelm Eisner (MD, PhD) Innsbruck (Austria) vice president, Christian Mantsch, Minden secretary, and a new treasurer, Philipp Slotty (MD, PhD) from Düsseldorf.
2) National relationships:
In the past we struggled with acceptance of our society by guideline committees in Germany (e.g. AWMF). We can now announce a partial success: we applied for acceptance in the national board for medical guidelines. We actively participated in conferences of the German pain consensus conference in Sept. 2016. Since we are now active member of the German Society for the study of pain, we are now integrated in the guideline process and will continue to push forward in this field.
3) International relationships:
We would like to introduce a European interim meeting in 2018, which are associated to the neighbor societies as the Scandinavian Chapter, Benelux, France/Swiss and the Austrian Society. This is of course work in progress, but we are confident to establish it in the near future. Hopefully we will be able to announce the meeting with details during the INS conference in Edinburgh this year.
4) Scientific activities:
We prepared presentations and posters for the next NANS as well as the upcoming INS Congress in Edinburgh 2017. We will implement scientific activities in Deep Brain Stimulation for Movement disorders, psychiatric indications and orphans diseases like Huntington’s chorea. Due to the new Eucomed guidelines, DGNM will provide more activities in travel grant requests for their members.
With best wishes to all the colleagues worldwide for 2017
Jan Vesper
Wilhelm Eisner
Christian Mantsch
Philipp Slotty
Düsseldorf, 04.01.2017
Italy
The incoming board was voted in during the annual scientific meeting in September:
Alessandro Dario – President
Genni Duse – Vice president
Gianni Colini Baldeschi – Secretary – Managing the relationships with foreign countries
Andrea Landi – Treasurer
Massimo Innamorato – Adviser
Giovanni Frigerio – Adviser
Beatrice Cioni – Adviser
Japan
The 30th annual meeting of the Japanese Neuromodulation Society was held on May 7, 2016 at the Toshi-Center Hotel in Tokyo. The main topics of this meeting were:
1) Deep brain stimulation (DBS) for depression, obsessive compulsive disorder, and Tourette syndrome
2) Comparison of new spinal cord stimulation systems (SCS) (Medtronic, St. Jude Medical, and Boston Scientific)
3) Comparison of DBS devices (Medtronic, St. Jude Medical, and Boston Scientific) and MRI-guided focused ultrasound for the treatment of movement disorders.
Also, topics about repetitive transcranial magnetic stimulation, botulinum toxin, and intrathecal baclofen were presented. The participation in the JNS meeting is increasing every year, and 150 people attended this year.
On the same day, we had a one-day seminar of about neuromodulation (a basic and clinical lecture for spinal cord stimulation and deep brain stimulation). We have hosted this seminar for nine years, and this is the 9th seminar. This year, 29 persons working in a device company (DBS and SCS) or agency for these instruments attended this seminar. We present an examination about SCS and DBS (basic and clinical) after the seminar. Each company evaluates the results of this examination, and they can use it for the feedback about their education.
We also have a hands-on seminar, which is on how to regulate DBS and SCS systems in involuntary movement disorders and intractable pain. This hands-on seminar is popular for neurologists. Now, we can use both DBS and SCS system made by Medtronic, St. Jude, and Boston.
Takamitsu Yamamoto MD, PhD
Representative, JNS
Nordic
The Nordic Neuromodulation Society held its 3rd annual meeting in Uppsala, Sweden in September.
Eighty participants spent two days in the historic Museum Gustavianum presenting and discussing current clinical and scientific work in the Nordic region. A long session devoted to discussing the members' own clinical cases turned out very successfully and will certainly be repeated in the future.
In addition to speakers from among the many Nordic specialists working in the field of neuromodulation, we were fortunate to have Professor Rod Taylor from Exeter University, U.K. He gave a lecture on the challenges of assessing cost-effectiveness of neuromodulation therapies. We thank all the speakers and especially Professor Taylor who had come a long way to give his highly relevant talk.
NNS treasurer Kari Sulkko (FI) and secretary Anders Wåhlstedt (SE) had decided to step down from the board, and the new NNS board is:
Denmark: Kaare Meier (chairman, re-elected)
Finland: Mikael Fraunberg
Norway: Audun Stubhaug (re-elected)
Sweden: Ala Ouraiby
Initiatives that were discussed at the meeting included, among other things, a Nordic network for nurses in neuromodulation and possible common Nordic follow-up guidelines.
For more details, please see http://nordicneuro.org/resources/documents.html
The next meeting is scheduled for October 2017 in Oslo, Norway.
United Kingdom and Ireland
The Neruomodulation Society of the United Kingdom and Ireland (NSUKI) recently arranged its annual scientific meeting (ASM) in Manchester from the 3rd to the 4th November. This was a joint meeting with the Neuropathic Pain Specialist Interest Group (of the British Pain Society) and the Specialist Nurse Practitioners in Neuromodulation (SPIN). This attracted 196 delegates with 10 exhibitors. It has returned a healthy profit.
Plans are underway to arrange our ASM for November 2017 that will be a joint meeting with SIGN (Specialist Interest Group in Neuromodulation). We hope to hold this meeting in Oxford or London. Our chapter is also looking forward to the INS meeting in Edinburgh in 2017 and the board have encouraged as many members to attend as possible. We are delighted to help support/assist this meeting in any way, and are already tasked with assisting in setting up a cadaveric workshop preceding the meeting and a satellite session in co-operation with Edinburgh Neurosciences.
There is a provisional idea to run a Pan-European meeting in 2018, in partnership with our other European chapters, but details about this have yet to be decided. At our AGM we agreed to set up and develop a research group led by Sam Eldabe (Dmitry Kruglov, James Fitzgerald). The aim would be to gather information on research groups across the membership, improve communication and apply for national research projects on behalf of NSUKI. We also were also keen to expand and improve our training programme and Abdul Laklhen has agreed to help the Board with this initiative. Barani Ganesan (and the Executive Board) is involved in delivering a high-frequency spinal cord stimulation master class on the 24th and 25th March 2017 in Leeds.
The Neuromodulation Registry is progressing – the pilot continues amongst the prior five units. We have a meeting with Industry on 13th January to further discuss funding of this project as we are very keen to complete this project. We felt that the issues previously outlined regarding NICOR could not be addressed and we have withdrawn from this collaboration. We have engaged the services of Northgate (this group run the National Joint Registry). A business case has been developed and sent to the industry members that we are due to meet in January.
Despite our ongoing efforts, intrathecal drug delivery to treat chronic non-malignant pain is still not being funded in the NHS. NSUKI remains a major stakeholder for any techniques being reviewed by NICE.
On behalf of the Board and our members may I wish you a Merry Christmas and Happy New Year.
Stana Bojanic
President NSUKI
December 2016
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