History of Neurostimulation




© Springer Science+Business Media New York 2016
Timothy R. Deer and Jason E. Pope (eds.)Atlas of Implantable Therapies for Pain Management10.1007/978-1-4939-2110-2_1


1. History of Neurostimulation



Timothy R. Deer  and Jimmy Mali 


(1)
The Center for Pain Relief, 400 Court Street, Suite 100, Charleston, WV 25301, USA

(2)
Department of Physical Medicine and Rehabilitation, University of North Carolina School of Medicine, Chapel Hill, NC, USA

 



 

Timothy R. Deer (Corresponding author)



 

Jimmy Mali



Keywords
NeuromodulationNeurostimulationSpinal cord stimulationHistorical perspectiveHistory



1.1 Introduction


When we discuss advances like dorsal root ganglion spinal cord stimulation, high frequency stimulation, burst delivery, MRI compatibility, Bluetooth innovation, and the potential of smart programming, one may ask whether we are already in the future. But Galvani, Volta, Franklin, and Gilbert may have posed the same question as they evolved the field. Interestingly, no matter what advances we see in our daily patient treatment, our phase of the advancement will be viewed as antiquated by those who follow. This is good news; we want to encourage innovation. But at the same time, we need to celebrate the history of the field. The purpose of this chapter is to examine, celebrate, and learn from past thinkers and scientists, and to apply what they have taught us to future thought.


1.2 The Ancient or Classical Age


Many of those involved in neuromodulation say that stimulation began in Mesopotamia with the use of the electric eel to treat foot pain and headache. The ancient history of this discipline is more complex and interesting than simplified version, however.

In Greece, the interest in currents and electrical properties was vast. The Greeks coined the word elektron to describe amber, a fossilized resin used to create sparks, and later this term became the modern root of the word electricity. Greek physicians were the initial users of current to treat illness, and along with the Mesopotamians, they were credited with the initial sparks that started what is now known as neurostimulation. The first documented use involved the release of electrically charged torpedo fish in clinical footbaths from the Nile to treat prolonged headache. Egyptian physicians called the electric fish “Thunderer of the Nile.” The use of electricity continued to develop in both Greece and Rome, and in some communities it was more common than the use of herbs and other medicinal treatments.


1.3 The Dark Ages and Forward


After well-documented use of electrical current in the classical age, the stage went silent for innovation for many centuries. This period has been referred to as the “dark ages” of neuromodulation history. Some use of these concepts may have been made, but documentation was poor, so the ability to teach new pupils and pass on knowledge seemed to evaporate. As time progressed, however, some individuals stepped up to move the field forward:



  • William Gilbert: This famous seventeenth-century scientist first used the term electricity and described the relationship of electromagnetism to the treatment of pain. Gilbert wrote of the use of lodestone, a piece of magnetic iron ore possessing polarity like a magnetic needle. He published reports of using lodestone therapy to treat headache, mental disorders, and marital infidelity. The mechanisms for treating infidelity were never theorized, and the use of electrical current was not well understood.


  • Ewald Georg von Kleist and Pieter van Musschenbroek: These two scientists were both instrumental in inventing the initial methods of harnessing energy via electrical current storage. Eventually their device become known as a Leyden jar, named after the University of Leyden (van Mussenchenbroek’s home town). Von Kleist, the bishop of Pomerania, tried to name the device the Kleistian jar, but this name was not adopted. The device was constructed by placing water in a metal container suspended by insulating silk cords, and placing a brass wire through a cork into the water. The process of harnessing electricity was critical to all future work in science and medicine. The work of von Kleist and van Musschenbroek made the development of neuromodulation possible.


  • Jean Jallabert: The work of von Kleist and van Musschenbroek was critical to the next major development. In 1746, Jallabert used electricity to stimulate muscle fibers. This advancement was used to successfully treat a paralyzed limb, resulting in involuntary contractions, regeneration of muscle, and increased blood flow. Jallabert’s success inspired many scientists, and over the following two decades there were several reports of successful treatment of neuromuscular disorders. This work, which seemed highly advanced for that time, led to the theory that electricity was a fluid.


  • John Walsh: The theory of electricity as a fluid was evaluated by Walsh, who dissected the torpedo fish and explained that the electrical organ of the animal was like the Leyden jar. The torpedo fish, lodestone, Leyden jar, and early muscle experiments were the foundation of neuromodulation that led to the future use of current therapies.


  • Henry Cavendish: In 1771, Cavendish explained the relationship between electrical force and distance in mathematical theory. This mathematical equation established the groundwork for many future electrical engineering advances.


  • Alessandro Giuseppe Antonio Anastasio Volta: Volta invented the first battery about 1800. His invention led to the ability to create modern devices.


  • Luigi Galvani: Galvani may be considered the father of modern neuromodulation. He created what we may term bioelectrics when he first used sparks to move the muscles of frog legs. This simple concept led to the first step of connecting electricity to an animal.


1.4 Neurostimulation First Used in the United States


Benjamin Franklin is important to neuromodulation for two reasons: The development of the lightening rod was an early practical use of electricity, and Franklin was also the first American to use neurostimulation. Franklin’s interest in electrical current peaked in 1756, after he learned about the work of Leopoldo Caldani, who reported that discharging a Leyden jar in the vicinity of a mounted and dissected frog’s leg could cause it to twitch. Many scientists touted electricity as a miracle cure for many diseases after the presentation of Caldani’s work. Especially popular was the hypothesis that paralysis might be cured by this method. Franklin did his own experiments on painful conditions. After discovering that his subjects experienced more discomfort than pain relief, he concluded that these claims were inflated. Unfortunately for Franklin’s volunteers, many of whom were desperate and hopeless people, he used high-voltage stimulation that caused injury, pain, and tissue burns.

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Oct 16, 2016 | Posted by in PAIN MEDICINE | Comments Off on History of Neurostimulation

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