Neuromodulation for Painful Diabetic Neuropathy: Mechanism of Action and Clinical Approach

Monday, September 19th
8:30am12:00pm EDT

About the Session

Neuromodulation Special Interest Group Symposium: AM Sessions

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Diabetic peripheral neuropathy (DPN) is a common, debilitating, and distressing complication of diabetes. Most patients develop painless, insensate distal nerve damage, increasing the risk of foot ulceration and subsequent amputation. Amputation is not only devastating in its impact on the person with diabetes and their family, leading to loss of independence and livelihood; it is also very expensive in material terms and results in only 50% surviving for two years.

Around a quarter of all diabetic patients also develop a chronic painful condition mainly affecting the legs which can result in considerable disability and suffering. Many such patients with painful DPN have depression, anxiety, fear, stress, and do not sleep well. Therefore an urgent need exists to detect DPN early by using objective, validated point-of-care devices (e.g. in a one-step microvascular screening service) as a clinical exam or the use of the 10-gram monofilament is not reliable. Early detection will lead to an earlier intervention to reduce risk factors for DPN development.

In four short state-of-the-art lectures, the most recent information on the role of neuromodulation in diabetic neuropathy will be presented. First, Dr John Markman will explore the interface between neuromodulation and pharmacological therapy in neuropathic pain research. Next, Dr Helena Knotknova will give an overview of the evidence related to the pain-releasing effects of non-invasive neuromodulation in the treatment of DPN.

Subsequent presentations will cover important recent developments in the field of neuromodulation therapy as an emerging and important tool for the pain physician to manage DPN. Including a review of mechanisms of action and (translational) insights from the laboratory with Prof Dr Bert Joostenn and an overview of the clinical evidence related to pain releasing effects of spinal cord stimulation in the treatment of DPN by Dr Ellan Sivanesan.

Learning Objectives:

  1. Overview of the evidence related to pain-relieving effects of non-invasive neuromodulation and pharmacology in the treatment of DPN
  2. Overview the mechanism(s) of action for neuromodulation and diabetic peripheral neuropathy.
  3. Evaluate the clinical evidence related to pain-relieving effects of spinal cord stimulation in the treatment of DPN



8:30 –  Symposia Begins and Opening Remarks

9:00-9:45 –  Interface Between Neuromodulation and Pharmacological Treatment in Neuropathic Pain with John Markman, MD

9:45-10:00 – Q&A

10:00-10:45 – Potential of Non-Invasive Neuromodulation for Symptom Management in Diabetic Neuropathy with Helena Knotkova, PhD

10:45-11:00 – Q&A

11:00-11:45 – Spinal Cord Stimulation and Painful Diabetic Polyneuropathy: Clinical Evidence for Pain Relief With Eellan Sivanesan, MD

11:45-12:00 – Closing Remarks