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1.
Elife ; 92020 05 13.
Article in English | MEDLINE | ID: mdl-32401198

ABSTRACT

Copy number alterations (CNAs) play an important role in molding the genomes of breast cancers and have been shown to be clinically useful for prognostic and therapeutic purposes. However, our knowledge of intra-tumoral genetic heterogeneity of this important class of somatic alterations is limited. Here, using single-cell sequencing, we comprehensively map out the facets of copy number alteration heterogeneity in a cohort of breast cancer tumors. Ou/var/www/html/elife/12-05-2020/backup/r analyses reveal: genetic heterogeneity of non-tumor cells (i.e. stroma) within the tumor mass; the extent to which copy number heterogeneity impacts breast cancer genomes and the importance of both the genomic location and dosage of sub-clonal events; the pervasive nature of genetic heterogeneity of chromosomal amplifications; and the association of copy number heterogeneity with clinical and biological parameters such as polyploidy and estrogen receptor negative status. Our data highlight the power of single-cell genomics in dissecting, in its many forms, intra-tumoral genetic heterogeneity of CNAs, the magnitude with which CNA heterogeneity affects the genomes of breast cancers, and the potential importance of CNA heterogeneity in phenomena such as therapeutic resistance and disease relapse.


Cells in the body remain healthy by tightly preventing and repairing random changes, or mutations, in their genetic material. In cancer cells, however, these mechanisms can break down. When these cells grow and multiply, they can then go on to accumulate many mutations. As a result, cancer cells in the same tumor can each contain a unique combination of genetic changes. This genetic heterogeneity has the potential to affect how cancer responds to treatment, and is increasingly becoming appreciated clinically. For example, if a drug only works against cancer cells carrying a specific mutation, any cells lacking this genetic change will keep growing and cause a relapse. However, it is still difficult to quantify and understand genetic heterogeneity in cancer. Copy number alterations (or CNAs) are a class of mutation where large and small sections of genetic material are gained or lost. This can result in cells that have an abnormal number of copies of the genes in these sections. Here, Baslan et al. set out to explore how CNAs might vary between individual cancer cells within the same tumor. To do so, thousands of individual cancer cells were isolated from human breast tumors, and a technique called single-cell genome sequencing used to screen the genetic information of each of them. These experiments confirmed that CNAs did differ ­ sometimes dramatically ­ between patients and among cells taken from the same tumor. For example, many of the cells carried extra copies of well-known cancer genes important for treatment, but the exact number of copies varied between cells. This heterogeneity existed for individual genes as well as larger stretches of DNA: this was the case, for instance, for an entire section of chromosome 8, a region often affected in breast and other tumors. The work by Baslan et al. captures the sheer extent of genetic heterogeneity in cancer and in doing so, highlights the power of single-cell genome sequencing. In the future, a finer understanding of the genetic changes present at the level of an individual cancer cell may help clinicians to manage the disease more effectively.


Subject(s)
Biomarkers, Tumor/genetics , Breast Neoplasms/genetics , DNA Copy Number Variations , Gene Dosage , Genetic Heterogeneity , Genomics , Single-Cell Analysis , Whole Genome Sequencing , Breast Neoplasms/mortality , Breast Neoplasms/pathology , Breast Neoplasms/therapy , Clinical Trials, Phase II as Topic , Female , Genetic Predisposition to Disease , Humans , Phenotype , Prognosis , RNA-Seq
2.
Science ; 360(6385): 171-175, 2018 04 13.
Article in English | MEDLINE | ID: mdl-29496957

ABSTRACT

Family trees have vast applications in fields as diverse as genetics, anthropology, and economics. However, the collection of extended family trees is tedious and usually relies on resources with limited geographical scope and complex data usage restrictions. We collected 86 million profiles from publicly available online data shared by genealogy enthusiasts. After extensive cleaning and validation, we obtained population-scale family trees, including a single pedigree of 13 million individuals. We leveraged the data to partition the genetic architecture of human longevity and to provide insights into the geographical dispersion of families. We also report a simple digital procedure to overlay other data sets with our resource.


Subject(s)
Family , Genealogy and Heraldry , Models, Genetic , Pedigree , Datasets as Topic , Humans , Longevity , Population
4.
Elife ; 62017 11 28.
Article in English | MEDLINE | ID: mdl-29182147

ABSTRACT

DNA re-identification is used for a broad suite of applications, ranging from cell line authentication to forensics. However, current re-identification schemes suffer from high latency and limited access. Here, we describe a rapid, inexpensive, and portable strategy to robustly re-identify human DNA called 'MinION sketching'. MinION sketching requires as few as 3 min of sequencing and 60-300 random SNPs to re-identify a sample enabling near real-time applications of DNA re-identification. Our method capitalizes on the rapidly growing availability of genomic reference data for cell lines, tissues in biobanks, and individuals. This empowers the application of MinION sketching in research and clinical settings for periodic cell line and tissue authentication. Importantly, our method enables considerably faster and more robust cell line authentication relative to current practices and could help to minimize the amount of irreproducible research caused by mix-ups and contamination in human cell and tissue cultures.


Subject(s)
DNA/genetics , Genotyping Techniques/methods , Sequence Analysis, DNA/methods , Computational Biology/methods , DNA/chemistry , Humans , Polymorphism, Single Nucleotide , Time Factors
5.
Nat Methods ; 14(6): 590-592, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28436466

ABSTRACT

Short tandem repeats (STRs) are highly variable elements that play a pivotal role in multiple genetic diseases, population genetics applications, and forensic casework. However, it has proven problematic to genotype STRs from high-throughput sequencing data. Here, we describe HipSTR, a novel haplotype-based method for robustly genotyping and phasing STRs from Illumina sequencing data, and we report a genome-wide analysis and validation of de novo STR mutations. HipSTR is freely available at https://hipstr-tool.github.io/HipSTR.


Subject(s)
Chromosome Mapping/methods , DNA Fingerprinting/methods , Genetic Predisposition to Disease/genetics , Genetic Variation/genetics , Genome, Human/genetics , Microsatellite Repeats/genetics , Algorithms , High-Throughput Nucleotide Sequencing , Humans , Sequence Alignment , Sequence Analysis, DNA , Software
6.
Bioinformatics ; 33(14): 2191-2193, 2017 Jul 15.
Article in English | MEDLINE | ID: mdl-28334237

ABSTRACT

MOTIVATION: Millions of individuals have access to raw genomic data using direct-to-consumer companies. The advent of large-scale sequencing projects, such as the Precision Medicine Initiative, will further increase the number of individuals with access to their own genomic information. However, querying genomic data requires a computer terminal and computational skill to analyze the data-an impediment for the general public. RESULTS: DNA Compass is a website designed to empower the public by enabling simple navigation of personal genomic data. Users can query the status of their genomic variants for over 1658 markers or tens of millions of documented single nucleotide polymorphisms (SNPs). DNA Compass presents the relevant genotypes of the user side-by-side with explanatory scientific resources. The genotype data never leaves the user's computer, a feature that provides improved security and performance. More than 12 000 unique users, mainly from the general genetic genealogy community, have already used DNA Compass, demonstrating its utility. AVAILABILITY AND IMPLEMENTATION: DNA Compass is freely available on https://compass.dna.land . CONTACT: yaniv@cs.columbia.edu.


Subject(s)
Genome, Human , Information Storage and Retrieval , Polymorphism, Single Nucleotide , Sequence Analysis, DNA/instrumentation , Software , Genetic Privacy , Humans , Precision Medicine
7.
Mol Cell ; 56(6): 796-807, 2014 Dec 18.
Article in English | MEDLINE | ID: mdl-25435137

ABSTRACT

The strength of conclusions drawn from RNAi-based studies is heavily influenced by the quality of tools used to elicit knockdown. Prior studies have developed algorithms to design siRNAs. However, to date, no established method has emerged to identify effective shRNAs, which have lower intracellular abundance than transfected siRNAs and undergo additional processing steps. We recently developed a multiplexed assay for identifying potent shRNAs and used this method to generate ∼250,000 shRNA efficacy data points. Using these data, we developed shERWOOD, an algorithm capable of predicting, for any shRNA, the likelihood that it will elicit potent target knockdown. Combined with additional shRNA design strategies, shERWOOD allows the ab initio identification of potent shRNAs that specifically target the majority of each gene's multiple transcripts. We validated the performance of our shRNA designs using several orthogonal strategies and constructed genome-wide collections of shRNAs for humans and mice based on our approach.


Subject(s)
RNA, Small Interfering/genetics , Software , Algorithms , Base Sequence , Cell Line, Tumor , Computer Simulation , Consensus Sequence , Gene Knockdown Techniques , Humans , MicroRNAs/genetics , Models, Genetic , Molecular Sequence Data
8.
Genetics ; 198(2): 647-68, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25081570

ABSTRACT

MiRNAs bear an increasing number of functions throughout development and in the aging adult. Here we address their role in establishing sexually dimorphic traits and sexual identity in male and female Drosophila. Our survey of miRNA populations in each sex identifies sets of miRNAs differentially expressed in male and female tissues across various stages of development. The pervasive sex-biased expression of miRNAs generally increases with the complexity and sexual dimorphism of tissues, gonads revealing the most striking biases. We find that the male-specific regulation of the X chromosome is relevant to miRNA expression on two levels. First, in the male gonad, testis-biased miRNAs tend to reside on the X chromosome. Second, in the soma, X-linked miRNAs do not systematically rely on dosage compensation. We set out to address the importance of a sex-biased expression of miRNAs in establishing sexually dimorphic traits. Our study of the conserved let-7-C miRNA cluster controlled by the sex-biased hormone ecdysone places let-7 as a primary modulator of the sex-determination hierarchy. Flies with modified let-7 levels present doublesex-related phenotypes and express sex-determination genes normally restricted to the opposite sex. In testes and ovaries, alterations of the ecdysone-induced let-7 result in aberrant gonadal somatic cell behavior and non-cell-autonomous defects in early germline differentiation. Gonadal defects as well as aberrant expression of sex-determination genes persist in aging adults under hormonal control. Together, our findings place ecdysone and let-7 as modulators of a somatic systemic signal that helps establish and sustain sexual identity in males and females and differentiation in gonads. This work establishes the foundation for a role of miRNAs in sexual dimorphism and demonstrates that similar to vertebrate hormonal control of cellular sexual identity exists in Drosophila.


Subject(s)
Drosophila melanogaster/genetics , Ecdysteroids/physiology , MicroRNAs/genetics , Animals , Cell Line , Drosophila melanogaster/metabolism , Female , Genome, Insect , Lymphoid Tissue/cytology , Male , MicroRNAs/metabolism , Organ Specificity , Ovary/metabolism , RNA Interference , Sex Characteristics , Sex Determination Processes , Testis/metabolism , Transcriptional Activation , Transcriptome
9.
10.
Nature ; 489(7414): 101-8, 2012 Sep 06.
Article in English | MEDLINE | ID: mdl-22955620

ABSTRACT

Eukaryotic cells make many types of primary and processed RNAs that are found either in specific subcellular compartments or throughout the cells. A complete catalogue of these RNAs is not yet available and their characteristic subcellular localizations are also poorly understood. Because RNA represents the direct output of the genetic information encoded by genomes and a significant proportion of a cell's regulatory capabilities are focused on its synthesis, processing, transport, modification and translation, the generation of such a catalogue is crucial for understanding genome function. Here we report evidence that three-quarters of the human genome is capable of being transcribed, as well as observations about the range and levels of expression, localization, processing fates, regulatory regions and modifications of almost all currently annotated and thousands of previously unannotated RNAs. These observations, taken together, prompt a redefinition of the concept of a gene.


Subject(s)
DNA/genetics , Encyclopedias as Topic , Genome, Human/genetics , Molecular Sequence Annotation , Regulatory Sequences, Nucleic Acid/genetics , Transcription, Genetic/genetics , Transcriptome/genetics , Alleles , Cell Line , DNA, Intergenic/genetics , Enhancer Elements, Genetic , Exons/genetics , Gene Expression Profiling , Genes/genetics , Genomics , Humans , Polyadenylation/genetics , Protein Isoforms/genetics , RNA/biosynthesis , RNA/genetics , RNA Editing/genetics , RNA Splicing/genetics , Repetitive Sequences, Nucleic Acid/genetics , Sequence Analysis, RNA
11.
RNA ; 18(1): 42-52, 2012 Jan.
Article in English | MEDLINE | ID: mdl-22096018

ABSTRACT

In animals a discrete class of small RNAs, the piwi-interacting RNAs (piRNAs), guard germ cell genomes against the activity of mobile genetic elements. piRNAs are generated, via an unknown mechanism, from apparently single-stranded precursors that arise from discrete genomic loci, termed piRNA clusters. Presently, little is known about the signals that distinguish a locus as a source of piRNAs. It is also unknown how individual piRNAs are selected from long precursor transcripts. To address these questions, we inserted new artificial sequence information into piRNA clusters and introduced these marked clusters as transgenes into heterologous genomic positions in mice and flies. Profiling of piRNA from transgenic animals demonstrated that artificial sequences were incorporated into the piRNA repertoire. Transgenic piRNA clusters are functional in non-native genomic contexts in both mice and flies, indicating that the signals that define piRNA generative loci must lie within the clusters themselves rather than being implicit in their genomic position. Comparison of transgenic animals that carry insertions of the same artificial sequence into different ectopic piRNA-generating loci showed that both local and long-range sequence environments inform the generation of individual piRNAs from precursor transcripts.


Subject(s)
Drosophila melanogaster/metabolism , RNA, Small Interfering/biosynthesis , Animals , Drosophila melanogaster/genetics , Mice , Mice, Transgenic , RNA, Small Interfering/chemistry , RNA, Small Interfering/genetics
12.
Genes Dev ; 24(22): 2499-504, 2010 Nov 15.
Article in English | MEDLINE | ID: mdl-20966049

ABSTRACT

Combining RNAi in cultured cells and analysis of mutant animals, we probed the roles of known Piwi-interacting RNA (piRNA) pathway components in the initiation and effector phases of transposon silencing. Squash associated physically with Piwi, and reductions in its expression led to modest transposon derepression without effects on piRNAs, consistent with an effector role. Alterations in Zucchini or Armitage reduced both Piwi protein and piRNAs, indicating functions in the formation of a stable Piwi RISC (RNA-induced silencing complex). Notably, loss of Zucchini or mutations within its catalytic domain led to accumulation of unprocessed precursor transcripts from flamenco, consistent with a role for this putative nuclease in piRNA biogenesis.


Subject(s)
Drosophila melanogaster/metabolism , RNA, Small Interfering/biosynthesis , Animals , Cells, Cultured , DNA Transposable Elements/physiology , Drosophila Proteins/genetics , Drosophila Proteins/metabolism , Drosophila melanogaster/genetics , Endoribonucleases/genetics , Endoribonucleases/metabolism , Female , Mutation , RNA Helicases/genetics , RNA Helicases/metabolism , RNA Interference , RNA, Small Interfering/genetics , RNA, Small Interfering/metabolism
13.
Bioinformatics ; 26(14): 1783-5, 2010 Jul 15.
Article in English | MEDLINE | ID: mdl-20562416

ABSTRACT

SUMMARY: Here, we describe a tool suite that functions on all of the commonly known FASTQ format variants and provides a pipeline for manipulating next generation sequencing data taken from a sequencing machine all the way through the quality filtering steps. AVAILABILITY AND IMPLEMENTATION: This open-source toolset was implemented in Python and has been integrated into the online data analysis platform Galaxy (public web access: http://usegalaxy.org; download: http://getgalaxy.org). Two short movies that highlight the functionality of tools described in this manuscript as well as results from testing components of this tool suite against a set of previously published files are available at http://usegalaxy.org/u/dan/p/fastq


Subject(s)
Genomics/methods , Software , Databases, Factual , Internet , Sequence Analysis, DNA/methods , User-Computer Interface
14.
IEEE Trans Inf Theory ; 56(2): 706-723, 2010 Feb.
Article in English | MEDLINE | ID: mdl-21451737

ABSTRACT

Over the past three decades we have steadily increased our knowledge on the genetic basis of many severe disorders. Nevertheless, there are still great challenges in applying this knowledge routinely in the clinic, mainly due to the relatively tedious and expensive process of genotyping. Since the genetic variations that underlie the disorders are relatively rare in the population, they can be thought of as a sparse signal. Using methods and ideas from compressed sensing and group testing, we have developed a cost-effective genotyping protocol to detect carriers for severe genetic disorders. In particular, we have adapted our scheme to a recently developed class of high throughput DNA sequencing technologies. The mathematical framework presented here has some important distinctions from the 'traditional' compressed sensing and group testing frameworks in order to address biological and technical constraints of our setting.

15.
Mol Cell ; 36(3): 445-56, 2009 Nov 13.
Article in English | MEDLINE | ID: mdl-19917252

ABSTRACT

Drosophila Argonaute-1 and Argonaute-2 differ in function and small RNA content. AGO2 binds to siRNAs, whereas AGO1 is almost exclusively occupied by microRNAs. MicroRNA duplexes are intrinsically asymmetric, with one strand, the miR strand, preferentially entering AGO1 to recognize and regulate the expression of target mRNAs. The other strand, miR*, has been viewed as a byproduct of microRNA biogenesis. Here, we show that miR*s are often loaded as functional species into AGO2. This indicates that each microRNA precursor can potentially produce two mature small RNA strands that are differentially sorted within the RNAi pathway. miR* biogenesis depends upon the canonical microRNA pathway, but loading into AGO2 is mediated by factors traditionally dedicated to siRNAs. By inferring and validating hierarchical rules that predict differential AGO loading, we find that intrinsic determinants, including structural and thermodynamic properties of the processed duplex, regulate the fate of each RNA strand within the RNAi pathway.


Subject(s)
Arabidopsis Proteins/metabolism , Drosophila Proteins/metabolism , MicroRNAs/metabolism , RNA, Small Interfering/metabolism , RNA-Induced Silencing Complex/metabolism , 3' Untranslated Regions , Animals , Arabidopsis Proteins/genetics , Argonaute Proteins , Base Pairing , Blotting, Northern , Cell Line , Drosophila Proteins/genetics , Drosophila melanogaster/cytology , Drosophila melanogaster/genetics , Drosophila melanogaster/metabolism , Immunoprecipitation , MicroRNAs/chemistry , MicroRNAs/genetics , Models, Biological , Nucleic Acid Conformation , Protein Binding , RNA Interference , RNA Precursors/genetics , RNA Precursors/metabolism , RNA, Double-Stranded/genetics , RNA, Double-Stranded/metabolism , RNA, Messenger/genetics , RNA, Messenger/metabolism , RNA, Small Interfering/chemistry , RNA, Small Interfering/genetics , RNA-Induced Silencing Complex/genetics , Thermodynamics
16.
Assist Technol ; 21(1): 25-7, 2009.
Article in English | MEDLINE | ID: mdl-19719060

ABSTRACT

This report describes the unusual case of an everyday-use prosthesis suspension system failure during the freefall phase of a skydiving jump. The case individual was a 53-year-old male with a left transtibial amputation secondary to trauma. He used his everyday prosthesis, a transtibial endoskeleton with push-button, plunger-releasing, pin-locking silicon liner suction suspension and a neoprene knee suspension sleeve, for a standard recreational tandem skydive. Within seconds of exiting the plane, the suspension systems failed, resulting in the complete prosthesis floating away. Several factors may have led to suspension system failure, including an inadequate seal and material design of the knee suspension sleeve and liner, lack of auxiliary suspension mechanisms, and lack of a safety cover overlying the push-button release mechanism. This is the first report, to our knowledge, to discuss prosthetic issues specifically related to skydiving. While amputees are to be encouraged to participate in this extreme sport, special modifications to everyday components may be necessary to reduce the possibility of prosthesis failure during freefall, parachute deployment, and landing.


Subject(s)
Artificial Limbs , Aviation , Leg , Prosthesis Failure , Adult , Humans , Male
17.
Genome Res ; 19(7): 1243-53, 2009 Jul.
Article in English | MEDLINE | ID: mdl-19447965

ABSTRACT

Next-generation sequencers have sufficient power to analyze simultaneously DNAs from many different specimens, a practice known as multiplexing. Such schemes rely on the ability to associate each sequence read with the specimen from which it was derived. The current practice of appending molecular barcodes prior to pooling is practical for parallel analysis of up to many dozen samples. Here, we report a strategy that permits simultaneous analysis of tens of thousands of specimens. Our approach relies on the use of combinatorial pooling strategies in which pools rather than individual specimens are assigned barcodes. Thus, the identity of each specimen is encoded within the pooling pattern rather than by its association with a particular sequence tag. Decoding the pattern allows the sequence of an original specimen to be inferred with high confidence. We verified the ability of our encoding and decoding strategies to accurately report the sequence of individual samples within a large number of mixed specimens in two ways. First, we simulated data both from a clone library and from a human population in which a sequence variant associated with cystic fibrosis was present. Second, we actually pooled, sequenced, and decoded identities within two sets of 40,000 bacterial clones comprising approximately 20,000 different artificial microRNAs targeting Arabidopsis or human genes. We achieved greater than 97% accuracy in these trials. The strategies reported here can be applied to a wide variety of biological problems, including the determination of genotypic variation within large populations of individuals.


Subject(s)
Arabidopsis/genetics , Cystic Fibrosis Transmembrane Conductance Regulator/genetics , DNA, Complementary/genetics , Escherichia coli/genetics , Gene Library , Sequence Analysis, DNA/methods , Computer Simulation , Cystic Fibrosis/genetics , Expressed Sequence Tags , Gene Expression Profiling , Humans , Mutation/genetics , Oligonucleotide Array Sequence Analysis , Polymerase Chain Reaction , RNA, Small Interfering/genetics , Species Specificity
18.
Pain Med ; 8(6): 525-30, 2007 Sep.
Article in English | MEDLINE | ID: mdl-17716327

ABSTRACT

OBJECTIVE: The purpose of this series was to explore a 12.5:1 fixed-dose ratio of an intravenous nalbuphine and naloxone mixture (NNM) for use in patients following gynecologic surgery. DESIGN AND PATIENTS: Open-label, nonrandomized case series. The first series was a dose-ranging investigation for 12 patients following elective total abdominal hysterectomy or myomectomy. In this series, fentanyl was used for intraoperative analgesia, and patients were assigned to a lower NNM (2.5 mg/0.2 mg) or to a higher NNM (5 mg/0.4 mg) dose group. The second series evaluated the fixed dose of 5 mg nalbuphine/0.4 mg naloxone for four patients undergoing ambulatory gynecologic procedures. In the second series, no opioid agents were administered intraoperatively to eliminate the possibility of mu-opioid reversal by naloxone postoperatively. OUTCOME MEASURES: Pain control was assessed using a Verbal Pain Scale (0-10). Vital signs, side effects, and adverse events were recorded to determine drug safety. RESULTS: In the first series, there were no adverse events; however, each patient required rescue medication (either morphine or fentanyl). In the second series, two of the four patients reported a reduction in pain following drug administration and did not require any further analgesic agents in the 3-hour postoperative period. One patient had an asymptomatic lowering of heart rate after receiving the drug. CONCLUSION: Additional research of the unique combination therapy of nalbuphine and naloxone is warranted to further determine its potential clinical efficacy and safety.


Subject(s)
Analgesics/administration & dosage , Gynecologic Surgical Procedures/adverse effects , Nalbuphine/administration & dosage , Naloxone/administration & dosage , Pain, Postoperative/drug therapy , Adult , Dose-Response Relationship, Drug , Drug Combinations , Female , Humans , Infusions, Intravenous , Middle Aged , Pain, Postoperative/etiology
19.
Am J Phys Med Rehabil ; 86(3): 225-41, 2007 Mar.
Article in English | MEDLINE | ID: mdl-17314708

ABSTRACT

Nanotechnology is a scientific movement that has the potential to transform the diagnosis and treatment of disease in the 21st century. The area of investigation is defined by the study, design, manipulation, manufacture, and control of materials or devices by physical or chemical means at resolutions on the order of one billionth of a meter. The potential for a wide range of clinical applications makes a basic understanding of nanotechnology important to physiatrists. This review presents an introduction to nanotechnology and discusses key developments in tissue engineering, drug delivery, imaging, diagnostics, surface texturing, and biointerfaces that could impact the practice of physiatry in the future.


Subject(s)
Nanotechnology , Physical and Rehabilitation Medicine , Clinical Laboratory Techniques , Dendrimers , Drug Delivery Systems , Genetic Therapy , Humans , Magnetics , Nanostructures , Physical and Rehabilitation Medicine/methods , Rehabilitation , Surface Properties , Tissue Engineering
20.
Neuromodulation ; 10(2): 133-41, 2007 Apr.
Article in English | MEDLINE | ID: mdl-22151862

ABSTRACT

Objective. Spinal cord stimulator (SCS) parameter settings have been well studied; however, the goal of this exploratory study was to examine the SCS parameters used during intra-operative stimulation (IOS) at trial lead placement. Methods. In this retrospective study, we report the IOS parameter settings for 22 patients who underwent thoracic SCS lead trial for treatment of refractory low back and/or leg pain. Results. Paresthesia coverage was shown to differ depending upon the pain syndrome and the region involved (back and/or leg, p = 0.03). Certain stimulation parameters were demonstrated to be linked, including pulse width with rate (p = 0.04) and bipolar activation distance with amplitude (p < 0.01). Important variations in field configuration practice patterns also emerged. Conclusions. Larger prospective studies are required to confirm and extend the current results. The ultimate goal for this report is to establish a foundation for future studies to create an evidence-based standardized algorithm for IOS to enhance the success rate of SCS trial screening.

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