Differential Target Multiplexed Spinal Cord Stimulator: A Review of Preclinical/Clinical Data and Hardware Advancement

Abstract

Spinal cord stimulation (SCS) is an effective neuromodulation technique for treating chronic neuropathic pain. Recent rapid growth in understanding its mechanism has led to the development of glial cell-based differential target multiplexed (DTM) stimulation and its derivative algorithm. Both preclinical research and clinical trials in humans showed superior pain relief using DTM SCS compared with traditional SCS. Another multicenter prospective clinical trial showed significant pain score reduction and energy saving using the DTM derivative algorithm. This review paper summarizes the evidence related to using DTM stimulation for other painful conditions such as nonsurgical low back pain and upper-limb pain. All these advanced programming options can be delivered using an innovative platform, the Medtronic Intellis™ neurostimulator.

Keywords::

• back pain
• differential target multiplexed
• glial cells
• Intellis™
• spinal cord stimulator

Author contributions

M Murphy is a consultant to Medtronic and Relievant. M Fishman is a consultant to Abbott, Aurora Pain Care, Biotronik, Biowave, Brixton Biosciences, Bridge Therapeutics, IMSE, Medtronic, and Nevro, and has stock in Aurora, Celeri Health, SGX International, and Thermaquil.

Financial & competing interests disclosure

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.