In the eighteenth century, the use of electrical current for treating pain was widespread and indiscriminate. According to historical records, the first time electricity was used in medicine was in the time of the Roman Empire, where the torpedo fish was used to treat headaches and painful gout. Įlectricity has been used in medicine since almost two thousand years ago. Due to its reversibility and safety, neuromodulative approaches are preferred over neuroablative procedures, which have been more commonly performed in the previous era. Spinal cord stimulation is a technique of neuromodulation, which consists of placing leads in the epidural space of the spinal cord, as a method to treat numerous types of disturbances. With regard to pain treatment, low frequency is applied to activate dorsal spinal tracts, periaqueductal gray matter, and motor cortex, while inhibitory stimulation is utilized for peripheral nerve, thalamic, and hypothalamic modulation. ![]() At present, neuromodulation is used for several neurological conditions such as epilepsy, movement disorders, psychiatric disease, spasticity and pain. Low frequency electrical stimulation has an excitatory effect, whereas, high frequency stimulation is applied to produce neuronal inhibition. ![]() The term neuromodulation is preferred over the term stimulation, as the former includes the excitation and inhibition techniques in a clearer fashion. The International Neuromodulation Society established that: Neuromodulation is defined as, “the therapeutic alteration of activity in the central, peripheral or autonomic nervous systems, electrically or pharmacologically, by means of implanted devices”. Neuromodulation is defined as the application of either an electric current or pharmacological agents used to change the neuron membrane permeability to ions, leading to an increase or decrease in its threshold for action potentials.
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