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Comprehensive Textbook of Principles,

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 Contents

List of Contributors ix 9. Neuromodulation and Neuronal Plasticity 103

Alon Y. Mogilner
Foreword xi
10. Fundamentals of Kilohertz Frequency Alternating
I Current Nerve Conduction Block of the Peripheral
Nervous System 111
DEFINING NEUROMODULATION Niloy Bhadra and Kevin L. Kilgore
Elliot S. Krames, Ali R. Rezai and P. Hunter Peckham
11. MRI and fMRI for Neuromodulation 121
1. Perspectives on the History of Neuromodulation-Relevant Francesco Sammartino, Vibhor Krishna and Ali R. Rezai
Societies3
Elliot S. Krames, Konstantin V. Slavin, Giancarlo Barolat, 12. Patient-Specific Modeling of Deep Brain Stimulation 129
Brian Simpson and Michael Stanton-Hicks Cameron C. McIntyre

2. Psychological Issues and Evaluation for Patients 13. Big Data and Deep Brain Stimulation 137
Undergoing Implantable Technology 15 Pierre-Francois D’Haese, Peter E. Konrad and
Daniel M. Doleys and Jeffery J. Dolce Benoit M. Dawant

3. Anatomy of the Nervous System 25 14. Fundamentals of Burst Stimulation of the Spinal

Joshua M. Rosenow Cord and Brain 147
Dirk De Ridder, Tim Vancamp and Sven Vanneste
4. Clinical Study Designs for Neuromodulation 41
Richard B. North and Jane Shipley 15. Spinal Cord Stimulation: Mechanisms of Action 161
Yun Guan, Kerry Bradley, John L. Parker, Elliot S. Krames
and Bengt Linderoth
II
16. Fundamentals and Mechanisms of Dorsal Root
INTRODUCTION TO THE Ganglion Stimulation 179
BRAIN INITIATIVE Jeffery Kramer, Allison Foster, Alexander R. Kent and
William Cusack
P. Hunter Peckham
17. Mechanisms of Action of Deep Brain Stimulation:
5. The Brain Initiative—Implications for a Revolutionary A Review 193
Change in Clinical Medicine via Neuromodulation Kendall H. Lee, Elizabeth M. Mosier and Charles D. Blaha
Technology55
Elizabeth M. Mosier, Michael Wolfson, Erika Ross, 18. Vagus Nerve Stimulation: Mechanism of Action 211
James Harris, Doug Weber and Kip A. Ludwig Kristl E.J. Vonck and Lars E. Larsen

III 19. Mechanisms of Action of Sacral Nerve and Peripheral

Nerve Stimulation for Disorders of the Bladder
FUNDAMENTALS AND MECHANISMS and Bowel 221
OF NEUROMODULATION William C. de Groat and Changfeng Tai

Joseph J. Pancrazio IV
6. Fundamentals of Electrical Stimulation 71 TECHNOLOGY AND DEVICES
John T. Mortimer and Narendra Bhadra
Kip A. Ludwig
7. The Safe Delivery of Electrical Currents and
Neuromodulation83 20. Electrodes for the Neural Interface 239
Stuart F. Cogan, Seth Hara and Kip A. Ludwig Dustin J. Tyler

8. Waveforms for Neural Stimulation 95 21. Implantable Neural Stimulators 275

Warren M. Grill P. Hunter Peckham and D. Michael Ackermann

vii
viii Contents

22. Microstimulators: Minimally Invasive Implantable 32. Implanted Sensors in Neuromodulation via Electrical

Neuromodulatory Devices 289 Stimulation451
Benjamin Pless and Amy M. Goodman John L. Parker

23. Designing Neuromodulation Devices for Feedback 33. Gaming for the Brain: Video Gaming to Rehabilitate
Control305 the Upper Extremity After Stroke 465
Christopher L. Pulliam, Erik J. Peterson, Jeffrey A. Herron Lynne V. Gauthier, Troy A. Richter, Lydia C. George
and Timothy Denison and Kathryn M. Schubauer

24. MRI Safety and Neuromodulation Systems 315 34. The Use of New Surgical Technologies for Deep
Steve G. Manker and Frank G. Shellock Brain Stimulation 477
Vibhor Krishna, Francesco Sammartino and Ali R. Rezai

V 35. Neuromodulation Using Optogenetics and Related

Technologies487
BRAIN, COMPUTER AND MACHINE Nigel P. Pedersen and Robert E. Gross
INTERFACING
Bin He VII
25. Brain–Computer Interfaces: Why Not Better? 341 SURGICAL PROCEDURES
John P. Donoghue AND TECHNIQUES
26. Noninvasive Brain–Computer Interfaces 357 Elliot S. Krames and Ali R. Rezai
Gerwin Schalk and Brendan Z. Allison
36. Deep Brain Stimulation: Surgical Technique 503
27. Invasive Brain–Computer Interfaces for Functional Alon Y. Mogilner, Andre G. Machado and Ali R. Rezai
Restoration379
Abidemi B. Ajiboye and Robert F. Kirsch 37. Spinal Cord Stimulation: Placement of Surgical
Leads via Laminotomy: Techniques and Benefits 513
28. Prospects for a Robust Cortical Recording Interface 393 Donald Y. Ye, Jonathan Riley, Ravichandra Madineni,
Andrew Shoffstall and Jeffrey R. Capadona Shannon W. Clark, Chengyuan Wu, Steven M. Falowski
and Ashwini D. Sharan
29. Advances in Invasive Brain–Computer Interface
Technology and Decoding Methods for Restoring 38. Subcutaneous Peripheral Nerve Field Stimulation
Movement and Future Applications 415 for Intractable Pain 523
Chad E. Bouton Konstantin V. Slavin, Dali Yin, Hang Yin and
Christy Gomez

VI 39. Surgical Placement of Leads for Occipital Nerve

Stimulation529
EMERGING TECHNOLOGIES Richard L. Weiner
AND TECHNIQUES
40. Surgical Technique: Intrathecal Medication Delivery
Ali R. Rezai System Implantation 537
Joshua M. Rosenow
30. Gene-Based Neuromodulation 429
Hilarie C. Tomasiewicz, Gary Kocharian and 41. Neuroprosthetic Surgical Strategies for Neuromuscular
Michael G. Kaplitt Stimulation543
Michael W. Keith and Harry A. Hoyen
31. Focused Ultrasound Ablation for Neurological
Disorders443 42. The Surgical Technique of Vagus Nerve Stimulator
Francesco Sammartino, Toacca Taylor, Ali R. Rezai Implantation551
and Vibhor Krishna Jeffrey W. Cozzens
 List of Contributors
D. Michael Ackermann Allergan, San Francisco, CA,
United States
Abidemi B. Ajiboye Case Western Reserve University,
Cleveland, Ohio, United States; Louis Stokes Cleveland
Department of Veterans Affairs Medical Center, Cleveland,
OH, United States
Brendan Z. Allison National Center for Adaptive
Neurotechnologies, Albany, NY, United States; University
of California San Diego, La Jolla, CA, United States
Giancarlo Barolat Barolat Neuroscience, Denver, CO,
United States
Narendra Bhadra Case Western Reserve University,
Cleveland, OH, United States
Niloy Bhadra Case Western Reserve University, Cleveland,
OH, United States
Charles D. Blaha Mayo Clinic, Rochester, MN, United States
Chad E. Bouton Feinstein Institute for Medical Research at
Northwell Health, Manhasset, NY, United States
Kerry Bradley Clinical Science & Research, Nevro
Corporation, Redwood City, CA, United States
Jeffrey R. Capadona Case Western Reserve University,
Cleveland, OH, United States; Louis Stokes Cleveland
VA Medical Center, Cleveland, OH, United States
Stuart F. Cogan University of Texas at Dallas, Richardson,
TX, United States
Jeffrey W. Cozzens Southern Illinois University School of
Medicine, Springfield, IL, United States
William Cusack St Jude Medical, Sunnyvale, CA, United States
Pierre-Francois D’Haese Vanderbilt University, Nashville,
TN, United States
Benoit M. Dawant Vanderbilt University, Nashville, TN,
United States
William C. de Groat University of Pittsburgh School of
Medicine, Pittsburgh, PA, United States
Dirk De Ridder University of Otago, Dunedin,
New Zealand; St Augustinus, Antwerp, Belgium
Timothy Denison Medtronic PLC, Minneapolis, MN,
United States
Jeffery J. Dolce Pain and Rehabilitation Institute,
Birmingham, AL, United States
Daniel M. Doleys Pain and Rehabilitation Institute,
Birmingham, AL, United States
John P. Donoghue Wyss Center for Bio and
Neuroengineering, Geneva, Switzerland; Brown University
Providence, Rhode Island, USA
Lars E. Larsen Ghent University Hospital, Ghent, Belgium
Steven M. Falowski St. Luke’s Neurosurgical Associates,
Bethlehem, PA, United States
ix
Allison Foster ABI Rehabilitation, Auckland, New Zealand
Lynne V. Gauthier The Ohio State University, Columbus,
OH, United States
Lydia C. George The Ohio State University, Columbus, OH,
United States
Christy Gomez University of Illinois at Chicago, Chicago,
IL, United States
Amy M. Goodman University of California, San Francisco,
CA, United States
Warren M. Grill Duke University, Durham, NC,
United States
Robert E. Gross Emory University School of Medicine,
Atlanta, GA, United States
Yun Guan The Johns Hopkins University, Baltimore, MD,
United States
Seth Hara Mayo Clinic, Rochester, MN, United States
James Harris ECS Federal, Arlington, VA, United States
Bin He University of Minnesota, Minneapolis, MN,
United States
Jeffrey A. Herron Medtronic PLC, Minneapolis, MN,
United States
Harry A. Hoyen Case Western Reserve University,
­MetroHealth Medical Center, Cleveland, Ohio,
United States
Michael G. Kaplitt Weill Cornell Medicine, New York, NY,
United States
Michael W. Keith Case Western Reserve University,
­MetroHealth Medical Center, Cleveland, Ohio,
United States
Alexander R. Kent St Jude Medical, Sunnyvale, CA,
United States
Kevin L. Kilgore Case Western Reserve University,
Cleveland, OH, United States; Louis Stokes Cleveland
­Veterans Affairs Medical Center, Cleveland, OH,
United States; MetroHealth Medical Center, Cleveland, OH,
United States
Robert F. Kirsch Case Western Reserve University,
Cleveland, Ohio, United States; Louis Stokes Cleveland
Department of Veterans Affairs Medical Center, Cleveland,
OH, United States
Gary Kocharian Weill Cornell Medicine, New York, NY,
United States
Peter E. Konrad Vanderbilt University, Nashville, TN,
United States
Jeffery Kramer St Jude Medical, Sunnyvale, CA, United
States; University of Illinois, Peoria, IL, United States
Elliot S. Krames Pacific Pain Treatment Center,
San Francisco, CA, United States
x List of Contributors
Vibhor Krishna The Ohio State University, Columbus, OH,
United States
Kendall H. Lee Mayo Clinic, Rochester, MN, United States
Bengt Linderoth Karolinska Institutet, Stockholm, Sweden
Kip A. Ludwig Mayo Clinic, Rochester, MN, United States
Andre G. Machado Cleveland Clinic, Cleveland, OH,
United States
Ravichandra Madineni Thomas Jefferson University,
Philadelphia, PA, United States
Steve G. Manker Medtronic Restorative Therapies Group,
Minneapolis, MN, United States
Cameron C. McIntyre Case Western Reserve University,
Cleveland, OH, United States
Alon Y. Mogilner NYU Langone Medical Center,
New York, NY, United States
John T. Mortimer Case Western Reserve University,
Cleveland, OH, United States
Elizabeth M. Mosier Mayo Clinic, Rochester, MN,
United States
Richard B. North Retired, Johns Hopkins University
School of Medicine, Baltimore, MD, United States;
The Neuromodulation Foundation, Baltimore, MD,
United States
Joseph J. Pancrazio The University of Texas at Dallas,
­Richardson, TX, United States
John L. Parker Saluda Medical, Sydney, NSW, Australia
P. Hunter Peckham Case Western Reserve University,
Cleveland, OH, United States
Nigel P. Pedersen Emory University School of Medicine,
Atlanta, GA, United States
Erik J. Peterson Medtronic PLC, Minneapolis, MN,
United States
Benjamin Pless Partners HealthCare Innovation,
Cambridge, MA, United States
Christopher L. Pulliam Medtronic PLC, Minneapolis, MN,
United States
Ali R. Rezai West Virginia University, Morgantown,
WV, United States
Troy A. Richter The Ohio State University, Columbus, OH,
United States
Jonathan Riley Thomas Jefferson University, Philadelphia,
PA, United States
Joshua M. Rosenow Northwestern University Feinberg
School of Medicine, Chicago, IL, United States
Erika Ross Mayo Clinic, Rochester, MN, United States
Francesco Sammartino The Ohio State University,
Columbus, OH, United States
Gerwin Schalk National Center for Adaptive
Neurotechnologies, Albany, NY, United States;
Albany Medical College, Albany, NY, United States;
State University of New York at Albany, Albany, NY,
United States
Kathryn M. Schubauer The Ohio State University,
Columbus, OH, United States
Ashwini D. Sharan Thomas Jefferson University,
Philadelphia, PA, United States
Frank G. Shellock University of Southern California,
Institute for Magnetic Resonance Safety, Education, and
Research, Los Angeles, CA, United States
Jane Shipley The Neuromodulation Foundation, Baltimore,
MD, United States
Andrew Shoffstall Case Western Reserve University,
Cleveland, OH, United States; Louis Stokes Cleveland VA
Medical Center, Cleveland, OH, United States
Brian Simpson Retired, Wales, United Kingdom
Konstantin V. Slavin University of Illinois at Chicago,
Chicago, IL, United States
Michael Stanton-Hicks Cleveland Clinic, Cleveland, OH,
United States
Changfeng Tai University of Pittsburgh School of Medicine,
Pittsburgh, PA, United States
Toacca Taylor The Ohio State University, Columbus, OH,
United States
Hilarie C. Tomasiewicz Weill Cornell Medicine, New York,
NY, United States
Dustin J. Tyler Case Western Reserve University,
Cleveland, OH, United States; Louis-Stokes Cleveland
Veterans Affairs Medical Center, Cleveland, OH,
United States
Tim Vancamp St Augustinus, Antwerp, Belgium
Sven Vanneste University of Otago, Dunedin,
New Zealand; St Augustinus, Antwerp, Belgium;
The University of Texas at Dallas, Dallas, TX, United States
Kristl E.J. Vonck Ghent University Hospital, Ghent,
Belgium
Shannon W. Clark Thomas Jefferson University,
Philadelphia, PA, United States; Sentara Neurosurgery
Specialists, Norfolk, VA, United States
Doug Weber Defense Advanced Research Projects Agency,
Arlington, VA, United States; University of Pittsburgh,
Pittsburgh, PA, United States
Richard L. Weiner THR Presbyterian Hospital of Dallas,
Dallas, TX, United States; University of Texas
Southwestern Medical School, Dallas, TX, United States
Michael Wolfson National Institute of Biomedical Imaging
and Bioengineering, Bethesda, MD, United States
Chengyuan Wu Thomas Jefferson University, Philadelphia,
PA, United States
Donald Y. Ye Thomas Jefferson University, Philadelphia, PA,
United States
Dali Yin University of Illinois at Chicago, Chicago, IL,
United States
Hang Yin University of Illinois at Chicago, Chicago, IL,
United States
 Foreword
Elliot S. Krames1, P. Hunter Peckham2, Ali R. Rezai3
1Pacific
Pain Treatment Center, San Francisco, CA, United States;
2CaseWestern Reserve University, Cleveland, OH, United States;
3West Virginia University, Morgantown, WV, United States
INTRODUCTION
The first edition of Neuromodulation was the first
textbook of its kind and dedicated to one of the fastest-
growing areas of medicine then and still today, the field
of neuromodulation, which is “technology that impacts
on the neural interface.” That first edition was published
by Elsevier on June 26, 2009 and has enjoyed the acclaim
of neuroscientists, biomedical engineers, and clinicians
alike as the first authoritative and comprehensive text-
book regarding this relatively new field. We, the editors
of Neuromodulation, in the first edition set out to harness
what was known regarding this diverse field, encompass-
ing the combined knowledge of not only neuroscience
and biomedical engineering but also the widely diverse
clinical fields of neurosurgery, anesthesiology pain med-
icine, urology, gastroenterology, physical medicine and
rehabilitation, cardiology, otology, ophthalmology, urog-
ynocology, orthopedic surgery, and various other key
stakeholders. Our first edition consisted of 91 chapters
by authors all known to be experts in their fields.
As the editors of the first edition, we are pleased to offer
our second edition of Neuromodulation. We have carefully
selected the authors/contributors for this edition because
they are the leading experts in their fields of interest, hav-
ing made significant contributions within the larger field
of neuromodulation. And, again, we thank them all for
their efforts and important contributions to this project.
Neuromodulation as a field has grown since the
publication of our first edition, and this second edition
reflects that growth, progress, and evolution in research,
technology, and clinical innovation. The original 91
chapters have grown to 144 chapters in this two-volume
book, reflecting the rapid advances, new applications
and technology, and overall growth in our field.
The field of neuromodulation has become one of the
premier and most innovative specialties of implanted
technology in the body to improve neurological deficits
and overall function of patients. New chapters and addi-
tions in this edition cover a variety of important topics
xi
that reflect the evolution and growth of neuromodula-
tion. These include chapters on stroke recovery and
neuromodulation for the senses, sections on the excit-
ing field of neuromodulation for disease management
or bioelectronic medicine, vagal nerve stimulation, and
brain/machine interfacing, a chapter on optogenetics,
and a section on the rapidly growing field of noninvasive
neuromodulation, including noninvasive brain stimula-
tion for stroke recovery, pain relief, cognition, depres-
sion, and anxiety, to name just a few. These are exciting
times for the field of neuromodulation, and as editors we
are sure that you will find this comprehensive offering
equally exciting, thought-provoking, and informative.
This second edition of Neuromodulation is divided into
2 volumes, 16 sections, and 144 chapters that represent
the entire scope of neuromodulation in 2017. Volume 1
has introductory chapters on neuromodulation as a field,
a section on the fundamentals of neuromodulation that
includes chapters on electrical stimulation of the ner-
vous system and various chapters on the mechanisms of
action of different forms of this stimulation, a section on
advances to technology/devices for neuromodulation,
sections on the various neuromodulation techniques used
for the control of pain, a section on neuromodulation for
functional disorders, a section dedicated to neurostimu-
lation for epilepsy, and a section on neuromodulation for
cognitive and behavioral disorders. Volume 2 includes
sections on neuromodulation for movement disorders,
epilepsy, behavioral and cognitive disorders, functional
restoration, organ system disorders (including cardiac,
pulmonary, gastrointestinal, and bladder disorders),
disease management (including diabetes, rheumatoid
arthritis, and inflammatory bowel disease), brain, com-
puter, and machine interfacing, noninvasive brain neu-
romodulation, and surgical technique, as well as sections
on the business end of neuromodulation and emerging
technologies and techniques, and finally a stand-alone
section with one chapter on the Brain Initiative.
On next page, we give a synopsis of our second
­edition by section, title, and author/authors.
xii
VOLUME 1
I 10. Fundamentals of Kilohertz Frequency Alternating Current
DEFINING NEUROMODULATION
Elliot S. Krames, Ali R. Rezai, P. Hunter Peckham
   1. Perspectives on the History of the Neuromodulation-
Relevant Societies
Elliot S. Krames, Konstantin V. Slavin, Giancarlo Barolat,
Brian Simpson and Michael Stanton-Hicks
   2. Psychological Issues and Evaluation for Patients Undergoing
Implantable Technology
Daniel M. Doleys and Jeffery J. Dolce
   3. Anatomy of the Nervous System
Joshua M. Rosenow
   4. Clinical Study Designs for Neuromodulation
Richard B. North and Jane Shipley
II
INTRODUCTION TO THE BRAIN
INITIATIVE
P. Hunter Peckham
   5. The Brain Initiative—Implications for a Revolutionary
Change in Clinical Medicine via Neuromodulation
Technology
Elizabeth M. Mosier, Michael Wolfson, Erika Ross,
James Harris, Doug Weber and Kip A. Ludwig
III
FUNDAMENTALS AND MECHANISMS
OF NEUROMODULATION
Joseph Pancrazio
   6. Fundamentals of Electrical Stimulation
J. Thomas Mortimer and Narendra Bhadra
   7. The Safe Delivery of Electrical Currents and
Neuromodulation
Stuart F. Cogan, Seth Hara and Kip A. Ludwig
   8. Waveforms for Neural Stimulation
Warren M. Grill
   9. Neuromodulation and Neuronal Plasticity
Alon Y. Mogilner
Foreword
Nerve Conduction Block of the Peripheral Nervous System
Niloy Bhadra and Kevin L. Kilgore
11. MRI and fMRI for Neuromodulation
Francesco Sammartino, Vibhor Krishna and Ali R. Rezai
12. Patient-Specific Modeling of Deep Brain Stimulation
Cameron C. McIntyre
13. Big Data and Deep Brain Stimulation
Pierre-Francois D’Haese, Peter Konrad and Benoit Dawan
14. Fundamentals of Burst Stimulation of the
Spinal Cord and Brain
Dirk De Ridder, Tim Vancamp and Sven Vanneste
15. Spinal Cord Stimulation: Mechanisms of Action
Yun Guan, Kerry Bradley, John L. Parker, Elliot S. Krames
and Bengt Linderoth
16. Fundamentals and Mechanisms of Dorsal Root Ganglion
Stimulation
Jeffery Kramer, Allison Foster, Alexander R. Kent and
William Cusack
17. Mechanisms of Action of Deep Brain Stimulation:
A Review
Kendall H. Lee, Elizabeth M. Mosier and Charles D. Blaha
18. Vagus Nerve Stimulation: Mechanism of Action
Kristl Vonck and Lars Emil Larsen
19. Mechanisms of Action of Sacral Nerve and Peripheral Nerve
Stimulation for Disorders of Bladder and Bowel
William C. de Groat and Changfeng Tai
IV
TECHNOLOGY AND DEVICES
Kip A. Ludwig
20. Electrodes for the Neural Interface
Dustin J. Tyler
21. Implantable Neural Stimulators
P. Hunter Peckham and D. Michael Ackermann Jr.
22. Microstimulators: Minimally Invasive Implantable
Neuromodulatory Devices
Benjamin Pless and Amy M. Goodman
 Foreword xiii
23. Designing Neuromodulation Devices for Feedback Control 33. Gaming for the Brain: Video Gaming to Rehabilitate the
Christopher L. Pulliam, Erik J. Peterson, Jeffrey A. Herron Upper Extremity After Stroke
and Timothy Denison Lynne V. Gauthier, Troy A. Richter, Lydia C. George and
Kathryn M. Schubauer
24. MRI Safety and Neuromodulation Systems
Steve G. Manker and Frank G. Shellock 34. The Use of New Surgical Technologies for Deep Brain
Stimulation
Vibhor Krishna, Francesco Sammartino and Ali R. Rezai

V 35. Neuromodulation Using Optogenetics and Related

Technologies
BRAIN, COMPUTER, AND MACHINE Nigel Pedersen and Robert E. Gross
INTERFACING
Bin He

25. Brain–Computer Interfaces: Why Not Better?

VII
John P. Donoghue SURGICAL PROCEDURES
26. Noninvasive Brain–Computer Interfaces
AND TECHNIQUES
G. Schalk and B.Z. Allison Elliot S. Krames, Ali R. Rezai

27. Invasive Brain–Computer Interfaces for Functional
Restoration
Abidemi B. Ajiboye and Robert F. Kirsch
28. Prospects for a Robust Cortical Recording Interface
Andrew Shoffstall and Jeffrey R. Capadona
29. Advances in Invasive Brain–Computer Interface Technology
and Decoding Methods for Restoring Movement and Future
Applications
Chad E. Bouton
36. Deep Brain Stimulation: Surgical Technique
Alon Y. Mogilner, Andre G. Machado and Ali R. Rezai
37. Spinal Cord Stimulation: Placement of Surgical Leads via
Laminotomy: Techniques and Benefits
Donald Y. Ye, Jonathan Riley, Ravichandra Madineni,
Shannon W. Clark, Chengyuan Wu, Steven M. Falowski
and Ashwini D. Sharan
38. Subcutaneous Peripheral Nerve Field Stimulation for
Intractable Pain
Konstantin V. Slavin, Dali Yin, Hang Yin and Christy Gomez

39. Surgical Placement of Leads for Occipital Nerve

VI Stimulation
Richard L. Weiner
EMERGING TECHNOLOGIES AND
TECHNIQUES 40. Surgical Technique: Intrathecal Medication Delivery System
Implantation
Ali R. Rezai
Joshua M. Rosenow
30. Gene-Based Neuromodulation
41. Neuroprosthetic Surgical Strategies for Neuromuscular
Hilarie C. Tomasiewicz, Gary Kocharian and
Stimulation
Michael G. Kaplitt
Michael W. Keith and Harry A. Hoyen
31. Focused Ultrasound Ablation for Neurological Disorders
42. The Surgical Technique of Vagus Nerve Stimulator
Francesco Sammartino, Toacca Taylor, Ali R. Rezai and
Implantation
Vibhor Krishna
Jeffrey W. Cozzens
32. Implanted Sensors in Neuromodulation via Electrical
Stimulation
John L. Parker
xiv
VOLUME 2
VIII
NEUROMODULATION FOR
PAIN CONTROL
VIII A
Spinal Cord Stimulation for Pain Control
Salim Hayek
43. Physiology and Pathophysiology of Chronic Pain
Nicole Bentley, Ahmed J. Awad and Parag G. Patil
44. Management Strategies for Chronic Pain
Keeley Dohmeier, Sailesh Arulkumar, Salim Hayek and
Lawrence Poree
45. History of Spinal Cord Stimulation
Richard B. North and Joshua P. Prager
46. Functional Magnetic Resonance Imaging in the
Neuromodulation of Pain
Ernest J. Barthélemy, Jonathan J. Rasouli, Kurt A. Yaeger and
Brian Harris Kopell
47. The Development of Algorithms for Pain Care Including
Neuromodulation Therapies: Introducing the SAFE
Principles
Prasad Shirvalkar, Lawrence Poree and Elliot S. Krames
48. Neurostimulation for the Treatment of Complex Regional
Pain Syndrome
Michael Stanton-Hicks and Joshua P. Prager
49. Spinal Cord Stimulation for Peripheral Neuropathic Pain
Brigitte A. Brouwer, Bert Joosten and Maarten van Kleef
50. Spinal Cord Stimulation for the Treatment of Low Back Pain
Richard B. North
51. Complications of Spinal Cord Stimulation
Mark N. Malinowski, Chong H. Kim and Timothy R. Deer
52. Clinical Aspects of Burst Stimulation for Pain Control
Stefan Schulte and Tim Vancamp
53. Dorsal Root Ganglion Stimulation for Pain Control
Paul Verrills
54. Ten Kilohertz (10 kHz) High-Frequency Spinal Cord
Stimulation
Kapural Leonardo and Adnan Al-Kaisy
55. A Review of Spinal Cord Stimulation Cost Studies
Jane Shipley and Richard B. North
Foreword
VIII B
Peripheral Nerve Stimulation for
Pain Control
Konstantin V. Slavin
56. Anatomy and Physiology Related to Peripheral Nerve
Stimulation
Michael Stanton-Hicks
57. Peripheral Nerve Stimulation for Pain Suppression
Joseph W. Boggs, John Chae and Maria E. Bennett
58. Peripheral Nerve Stimulation for Facial Pain
Konstantin V. Slavin, Dali Yin and Serge Rasskazoff
59. Combined Spinal Cord Stimulation and Peripheral Nerve
Field Stimulation for the Treatment of Chronic Back and
Neck Pain
Dali Yin and Konstantin V. Slavin
60. Percutaneous Peripheral Nerve Stimulation for the
Management of Postoperative Pain
Amorn Wongsarnpigoon and Brian M. Ilfeld
61. Peripheral Nerve Field Stimulation for Intractable Pain
Giancarlo Barolat
62. Occipital Neurostimulation for Treatment of Intractable
Headache Syndromes
Richard L. Weiner and Kenneth M. Alo
63. Neuromodulation for Headaches—Sphenopalatine Ganglion
Stimulation
Stewart J. Tepper and Anthony Caparso
VIII C
Intrathecal Therapies for Pain Control
and the Control of Spasticity
Lawrence Poree
64. Relevant Anatomy for Spinal Drug Delivery
Mark N. Malinowski, Chong H. Kim and Timothy R. Deer
65. Evolution of the Spinal Delivery of Opiate Analgesics
Deepali Dhar, Lawrence Poree and Tony L. Yaksh
66. Pharmacology of Intrathecal Therapy
Lucas W. Campos and Jason E. Pope
67. Cerebrospinal Fluid Dynamics and Intrathecal Delivery
Kevin Tangen, Ankit I. Mehta and Andreas A. Linninger
 Foreword xv
68. Exploring Nonopioid Analgesic Agents for Intrathecal Use
Jason Kyung-soo Hong and Richard Rauck
X
NEUROSTIMULATION FOR EPILEPSY
69. Potent Neurotoxins for Cancer Pain Treatment:
Resiniferatoxin and Saporin Jonathan Riley, Ashwini D. Sharan
Michael S. Leong and David Copenhaver
81. Epilepsy: Anatomy, Physiology, Pathophysiology,
70. The Development of Guidelines for Intrathecal Therapies and Disorders
for Pain Control: History and Present Guidelines Robrecht Raedt, Dominique M. Durand, Paul Boon, Kristl Vonck
Mark N. Malinowski, Chong H. Kim and Timothy R. Deer and Elliot S. Krames

71. Compounding for Intrathecal Analgesic Agents 82. Vagal Nerve Stimulation

William A. Stuart Vivek Mehta, Daniel Kramer, Jonathan Russin, Charles Liu
and Arun Amar
72. Intrathecal Baclofen Therapy for the Control of Spasticity
Michael Saulino 83. Deep Brain Stimulation for Epilepsy
Paul Koch and Gordon Baltuch

84. Closed-Loop Responsive Stimulation for Epilepsy

VIII D Abraham Sabersky, Michael Mackow, Balu Krishnan,
Intracranial Procedures for Dileep Nair, Andreas Alexopoulos, William Bingaman
and Jorge Gonzalez-Martinez
Chronic Pain
Alon Y. Mogilner XI
73. Deep Brain Stimulation for Pain NEUROMODULATION FOR
Neil Barua and Nik Patel
BEHAVIORAL AND COGNITIVE
DISORDERS
IX
Paul E. Holtzheimer
NEUROMODULATION FOR
MOVEMENT DISORDERS 85. Deep Brain Stimulation for Obsessive–Compulsive Disorder
Mayur Sharma, Kevin Reeves, Milind Deogaonkar and
Brian Harris Kopell Ali R. Rezai

74. Deep Brain Stimulation in Parkinson’s Disease 86. High-Intensity Focused Ultrasound Surgery for the Treatment
Reversa Mills-Joseph, Vibhor Krishna, Milind Deogaonkar of Obsessive–Compulsive Disorder
and Ali R. Rezai Young Goo Kim, Na Young Jung and Jin Woo Chang

75. Deep Brain Stimulation for Tremor 87. Deep Brain Stimulation for Highly Refractory Depression
Michael Pourfar, Michael Okun, Kelly Foote and Alon Y. Mogilner Darin D. Dougherty, Alik S. Widge and Benjamin D. Greenberg

76. Deep Brain Stimulation for Dystonia 88. Neuromodulation in Anorexia Nervosa

Ron L. Alterman and Scellig Stone Nir Lipsman, Andres M. Lozano and Clement Hamani

77. Deep Brain Stimulation in Tourette Syndrome 89. Deep Brain Stimulation for Alcoholism
Pablo Andrade, Martin Klehr and Veerle Visser-Vandewalle Sina Kohl and Jens Kuhn

78. Surgical Management of Hemifacial Spasm and Meige 90. Surgical Treatment for Refractory Drug Addiction
Syndrome Chencheng Zhang, Tao Wang, Kristina Zeljic, Haiyan Jin,
Na Young Jung and Jin Woo Chang Shikun Zhan, Dianyou Li, Xuelian Wang and Bomin Sun

79. Deep Brain Stimulation of the Pedunculopontine Tegmental 91. Subgenual Cingulate Deep Brain Stimulation for
Nucleus Improves Static Balance in Parkinson’s Disease Treatment-Resistant Depression
Paolo Mazzone, Flora Vitale, Annamaria Capozzo, Fabio Viselli Yarema B. Bezchlibnyk, Jennifer Cheng, Kelly R. Bijanki,
and Eugenio Scarnati Helen S. Mayberg and Robert E. Gross

80. Infusion Therapy for Movement Disorders 92. Cortical Stimulation for Depression

Neil Barua and Steven Gill Jeffrey Gilligan, Jonathan J. Rasouli and Brian Harris Kopell
xvi Foreword
VOLUME 3
XII
NEUROMODULATION FOR
FUNCTIONAL RESTORATION
P. Hunter Peckham and Kevin L. Kilgore
93. The History of Neuromuscular Electrical Stimulation—The
Evolution of Functional Neuromuscular Stimulation and
Future Directions
P. Hunter Peckham
94. Functional Electrical Stimulation for Return of Function
After Stroke
Jayme S. Knutson, Richard D. Wilson, Nathaniel S. Makowski
and John Chae
95. Invasive Neurostimulation for Poststroke Motor Recovery
Connor A. Wathen, Kenneth B. Baker and Andre G. Machado
96. Stimulation for Return of Upper-Extremity Function
Kevin L. Kilgore and P. Hunter Peckham
97. Lower-Extremity Motor System Neuroprostheses
Musa Audu, Rudi Kobetic, Stephen Selkirk and Ronald J. Triolo
98. Neuromodulation of the Spinal Cord for Movement Restoration
Susan Jill Harkema
99. A Brief History of the Cochlear Implant and Related Treatments
Blake S. Wilson and Michael F. Dorman
100. Stimulation for the Return of Hearing
Blake S. Wilson and Michael F. Dorman
101. The Development of Visual Prosthetic Devices to Restore
Vision to the Blind
James Weiland, Mark Humayun and Alejandra Gonzalez Calle
102. Neuromodulation for Treatment of Dry Eye
Manfred Franke, James D. Loudin, D. Michael Ackermann Jr.
103. Neuroprostheses for Restoring Sensation
Dustin J. Tyler
XIII
NEUROMODULATION FOR ORGAN
SYSTEMS
XIII A
Neuromodulation for Cardiovascular
Disorders
William T. Abraham
104. Autonomic Control of the Heart
Una Buckley and Jeffrey L. Ardell
105. Spinal Cord Stimulation for Peripheral Vascular Disorders
Stefan Schulte and Svante Horsch
106. Neuromodulation for Refractory Angina and Heart Failure
Paulin Andréll
107. Baroreceptor Activation for Hypertension and Heart Failure
Marabel Schneider, Ayhan Yoruk and John P. Gassler
XIII B
Neuromodulation for Pulmonary Disorders
Peter Staats
108. Upper-Airway Neurostimulation to Treat Obstructive
Sleep Apnea
Elizabeth G. Damato, Michael J. Decker, Matthew A. Schiefer,
Jonathan Z. Baskin, Girriso F. Benderro and Kingman P. Strohl
109. A Neural Prosthesis for Obstructive Sleep Apnea
Dominique M. Durand
110. Transvenous Phrenic Nerve Stimulation for Central Sleep
Apnea
William T. Abraham and Robin Elizabeth Germany
111. Neurostimulation for Asthma
Peter Staats, Charles Emala, Bruce Simon and J.P. Errico
112. Stimulation for Inspiration
Raymond P. Onders
113. Restoration of Cough via Functional Electrical Stimulation
Anthony F. Dimarco and Krzysztof E. Kowalski
XIII C
Neuromodulation for Gastrointestinal
Disorders
Elliot S. Krames, Jiande D.Z. Chen, Thomas Abell
114. Neural Control of the Gastrointestinal System
Drew Carl Drennan Murray and Thomas Abell
115. Spinal Cord Stimulation for Chronic Abdominal Pain
Leonardo Kapural
116. Emerging Gastric Stimulation for Dysmotility Disorders and
Obesity
Jiande D.Z. Chen and Jieyun Yin
117. Intestinal Electrical Stimulation: Methodologies, Effects,
Mechanisms, and Applications
Jieyun Yin and Jiande D.Z. Chen
118. Neuromodulation for Nausea and Vomiting in Adult Patients
Drew Carl Drennan Murray and Thomas Abell
 Foreword
119. Neuromodulation for Gastrointestinal Dysmotility in
Pediatric Patients
Peter L. Lu and Hayat M. Mousa
120. Colonic Electrical Stimulation for Constipation
Shukun Yao and Yanmei Li
XIII D
Neuromodulation for Urogenital Disorders
Roger Dmochowski and Joshua Aaron Cohn
121. Neurophysiology and Neuroanatomy of the Genitourinary
Organs
William C. de Groat
122. Sacral Nerve Stimulation
Magdy Hassouna and Ali Alabbad
123. Sacral Nerve Root Stimulation for Bladder Pain Syndrome/
Interstitial Cystitis
Sachin Malde, Arun Sahai and Adnan Al-Kaisy
124. Restoration of Bladder and Bowel Control After Spinal Cord
Injury
Graham H. Creasey
XIV
NEUROMODULATION FOR
ENDOCRINE, IMMUNE, AND
INFLAMMATORY DISORDERS
Christopher J. Czura and Chad E. Bouton
125. Vagus Nerve Stimulation and Regulation of Inflammation
Peder S. Olofsson
126. Activation of the Inflammatory Reflex in Rheumatoid
Arthritis and Inflammatory Bowel Disease: Preclinical
Evidence
Yaakov A. Levine, Michael Faltys and Ralph Zitnik
127. Bioelectronic Therapy for the Treatment of Rheumatoid
Arthritis and Inflammatory Bowel Disease
Yaakov A. Levine, Jesse Simon, Michael Faltys and Ralph Zitnik
128. Vagal Nerve Stimulation versus Sacral Nerve Stimulation for
Control of Inflammation
Jiande D.Z. Chen, Haifeng Jin and Jieyun Yin
129. Neuromodulation Therapies for Cardiac Disease
Siamak Salavatian and Jeffrey L. Ardell
130. The Neural Tourniquet
Jared M. Huston, Jason R. Fritz and Christopher J. Czura
131. Sensing and Decoding Neural Signals for Closed-Loop
Neuromodulation and Advanced Diagnostics in Chronic
Disease and Injury
Chad E. Bouton and Christopher J. Czura
xvii
132. The Role of Vagus Nerve Stimulation in the Treatment of
Central and Peripheral Pain Disorders and Related Comorbid
Somatoform Conditions
J.P. Errico
133. Insulin Resistance, Glucose Metabolism, Inflammation, and
the Role of Neuromodulation as a Therapy for Type 2 Diabetes
J.P. Errico
XV
NONINVASIVE NEUROMODULATION
Felipe Fregni
134. Transcranial Magnetic Stimulation
Jorge Leite, Marcel Simis, Sandra Carvalho and Felipe Fregni
135. Transcranial Direct Current Stimulation (tDCS)
Gozde Unal and Marom Bikson
136. Transcranial Alternating Current Stimulation and
Transcranial Random Noise Stimulation
Sandra Carvalho, Jorge Leite and Felipe Fregni
137. Novel Methods of Transcranial Stimulation:
Electrosonic Stimulation
Timothy Wagner and Laura Dipietro
138. Optimization of Noninvasive Brain Stimulation Clinical Trials
Aurore Thibaut, Melanie French, Alejandra Vasquez and Felipe
Fregni
139. Transcranial Direct Current Stimulation for Fatigue and
Attentional Disorders
Richard Andrew McKinley
XVI
THE BUSINESS END OF
NEUROMODULATION
P. Hunter Peckham
140. Perspectives on the Issues and Barriers to Starting a
New Neuromodulation Company From New Start-Ups
in Neuromodulation
Elliot S. Krames, Jon Snyder, Anthony Arnold,
Yaakov A. Levine, Maria E. Bennett and Laura Perryman
141. The Birth of an Industry
James Cavuoto
142. Neuromodulation: Regulatory Considerations
Megan Moynahan
143. Reimbursement for Neuromodulation Therapies and
Technologies
Elliot S. Krames, Alon Y. Mogilner, Rui V. Duarte,
Simon J. Thomson and Fabian Piedemonte
144. Perspective on How to Build a Neuromodulation Practice
Giancarlo Barolat, Alon Y. Mogilner and Joshua P. Prager
xviii Foreword
FIGURE 1 US and worldwide neuromodulation systems market, 2016–2020.
The clinical information presented in this second edition,
as in the first, is balanced and up to date. We hope that you,
the reader, enjoy the organization of and contributions to
this textbook. We also understand that we have attempted
to condense a very wide field of interest to various indi-
viduals from diverse backgrounds and focus into one book,
so we hope this book will have something of interest for all
who either work or have a primary interest in the field. We
believe it is a comprehensive textbook that should and will
define the field of neuromodulation for scientists, bioengi-
neers, clinicians, and members of the industry for years to
come, or at least until the publication of our third edition.
This edition of Neuromodulation is dedicated to one of
the fastest-growing fields in medicine today, as was the
first edition in 2009 (Fig. 1).
This figure shows the growing neuromodulation mar-
ket between 2016 and 2020. By the year 2020 the market
is expected to reach $3bn.
WHAT IS NEUROMODULATION?
Neuromodulation is the process of inhibition, stimu-
lation, modification, or therapeutic alteration of activ-
ity, electrically or chemically, in the central, peripheral,
or autonomic nervous systems. It is the science of how
electrical, chemical, and mechanical interventions can
modulate the nervous system, it is inherently nonde-
structive, and its physiological effect is reversible. The
INS defines neuromodulation as “the alteration of nerve
activity through targeted delivery of a stimulus, such as
electrical stimulation or chemical agents, to specific neu-
rological sites in the body.”
Other Neuromodulation Definitions and Terms
The term neuromodulation can be defined as a technol-
ogy that affects neural interfaces and is the science of
how electrical, chemical, and mechanical interventions
can modulate or change central and peripheral nervous
system functioning. It is a form of therapy in which neu-
rophysiological signals are initiated or influenced with
the intention of achieving therapeutic effects by alter-
ing the function and performance of the nervous sys-
tem. The term neuromodulation, in the opinion of these
authors, should replace other terms that are relevant to
and being used in the field, including neuroaugmenta-
tion, neurostimulation, neuroprosthetics, functional elec-
trical stimulation (FES), assistive technologies, and neural
engineering (Sakas et al., 2007). Neuroaugmentation is
defined by the OnLine Medical Dictionary as the use of
electrical stimulation to supplement the activity of the
nervous system (http://cancerweb.ncl.ac.uk/cgi-bin/
omd?neuroaugmentation). Neurostimulation is a process
or technology that applies electrical currents, in varying
parameters, by means of implanted electrodes to achieve
functional activation or inhibition of specific neuronal
groups, pathways, or networks. FES is defined as a tech-
nique that uses electrical currents to activate nerves inner-
vating extremities affected by paralysis resulting from
spinal cord injury, head injury, stroke, or other neurologic
disorders, restoring function in people with disabilities
(Wikipedia: http://en.wikipedia.org/wiki/Functional_
electrical_stimulation). FES is electrical stimulation of a
muscle to provide normal control to produce a functional
useful contraction, thus electrical stimulation that pro-
duces only sensory response cannot be termed as FES and
electrical stimulation that reduces pain is also not FES.
Neuroprosthetics “is a discipline related to neuroscience
and biomedical engineering concerned with developing
neural prostheses, artificial devices to replace or improve
the function of an impaired nervous system. The neuro-
prosthetic that has the most widespread use today is the
cochlear implant with approximately 100,000 in world-
wide use as of 2006” (Wikipedia: http://en.wikipedia.
org/wiki/Neuroprosthetics). Neural engineering is an
 Foreword
FIGURE 2 Neurostimulation addressable population (000s patients). US qualitative research with referrers and potential implanters; literature search;
internal discussion; analysis.
emerging interdisciplinary field of research that uses engi-
neering techniques to investigate the function and manip-
ulate the behavior of the central or peripheral nervous
systems. It draws heavily on the fields of computational
neuroscience, experimental neuroscience, clinical neu-
robiology, electrical engineering, and signal processing
of living neural tissue, and encompasses elements from
robotics, computer engineering, neural tissue engineering,
materials science, and nanotechnology (Answers.Com,
http://www.answers.com/topic/neural-engineering).
In 2017 devices for neuromodulation are either neural
stimulators, neural receivers/stimulators, a combination
of neural receivers, computers, and machine actuators or
micropumps (IDDS) that “target” deliver analgesic and
nonanalgesic medications. The major applications of these
devices are for the management of chronic pain, for disor-
ders of pacing, ionotropy and chronotropy, movement dis-
orders, mood disorders, dysmotility disorders, spasticity,
epilepsy, hearing and seeing disorders, and brain–machine
interfacing for speech and functional recovery from paraly-
sis. Newer applications of these devices include depression,
disorders of cognition, recovery from stroke, and treatment
of inflammatory diseases such as type 2 diabetes, rheuma-
toid arthritis, and inflammatory bowel disease (see Fig. 2).
Fig. 2 shows some of the disorders and the numbers of
persons affected by them who could be treated by neuro-
stimulation, a form of neuromodulation.
One of the purposes of this textbook is to provide our
readers with an improved awareness and understanding
of the fundamental science of the field of neuromodula-
tion, the engineering design basics for neuromodulatory
technologies, the mechanisms of action of these devices
on the nervous system, and the clinical applications for
their uses. In light of the fact that neuromodulation of
the nervous system is capable of modulating all the func-
tions of the human body, prospects for advancing our
field of neuromodulation are significant and growing.
We, the authors, dedicate this second edition of this text-
book to this ever-expanding field.
xix
Jan Holsheimer (2003) suggests that for a therapy to
be considered neuromodulation, it must consist of the
following.
1. T he therapy must be dynamic, ongoing (continuous
or intermittent) intervention, and not a short and
nonrecurring procedure.
2. The activity of specific neural networks of part of its
afferents is affected by ongoing electrical stimulation
or ongoing neuropharmacological stimulation,
which increases the concentration of a specific
neurotransmitter.
3. The clinical effect is continuously controllable by
the varying one or more stimulation parameters to
satisfy a patient’s need.
  
Neuromodulation is thus either electrical or chemi-
cal. Electrical neuromodulation is electrical stimula-
tion of the brain, the retina, the cochlea, the spinal
cord, peripheral nerves, plexuses of nerves, the auto-
nomic system, the gut, or the bladder and FES of the
muscles, while chemical neuromodulation places
chemical agents directly in contact with neural tis-
sues using implantation technology such as epidural
or intrathecal delivery systems. Neuromodulation,
paraphrasing Jan Holsheimer (2003), should be con-
cerned with long-term treatment of long-term, chronic
conditions.
Because the nervous system controls body functions
and disorders of body functions are ubiquitous, many
clinical specialists, including anesthesiologists, cardiolo-
gists, gastroenterologists, neurologists, neurosurgeons,
ophthalmologists, otolaryngologists, pain physicians,
psychiatrists, physiatrists, and urologists, to name a few,
use the therapies of neuromodulation.
This second edition of Neuromodulation reflects
the ever-increasing knowledge base of the field. We,
the editors, hope that you will enjoy the sections and
chapters of our offering, and find them interesting and
informative.
xx Foreword
References
Answers.Com. http://www.answers.com/topic/neural-engineering.
http://en.wikipedia.org/wiki/Functional_electrical_stimulation.
http://en.wikipedia.org/wiki/Neuroprosthetics.
Holsheimer, J., 2003. Letters to the editor. Neuromodulation 6 (4),
270–273.
OnLine Medical Dictionary. http://cancerweb.ncl.ac.uk/cgibin/
omd?neuroaugmentation.
Sakas, D.E., Panourias, I.G., Simpson, B.A., Krames, E.S., 2007. An intro-
duction to operative neuromodulation and functional neuropros-
thetics, the new frontiers of clinical neuroscience and biotechnology.
In: Sakas, Simpson, Krames (Eds.), Operative Neuromodulation,
vol. 1. Springer Verlag, Vienna, Austria, pp. 3–10.
Further Reading
Abel, N.A., Smith, R.A., 1994. Intrathecal baclofen for treatment of
intractable spinal spasticity. Arch. Phys. Med. Rehabil. 75, 54–58.
About.Com. http://inventors.about.com/library/inventors/blcardiac.
htm.
Albright, A.L., Barron, W.B., Fasick, M.P., et al., 1993. Continuous intra-
thecal baclofen infusion for spasticity of cerebral origin. JAMA 270,
2474–2477.
Albright, A.L., Barry, M.K., Shafton, D.H., Ferson, S.S., October 2001.
Intrathecal baclofen for generalized dystonia. Dev. Med. Child
Neurol. 43 (10), 652–657.
American Psychiatric Association, 1994. Mood Disorders: Diagnostic
and Statistical Manual of Mental Disorders, fourth ed. American
Psychiatric Association, Washington, DC, p. 320.
American Psychiatric Association, 2000. A Quick Reference to the
Diagnostic Criteria from DSM-IV-TR. American Psychiatric
Association, Arlington, VA.
Avellino, A.M., Loeser, J.D., 2000. Intrathecal baclofe for the treat-
ment of intractable spasticity of thespine or brain etiology.
Neuromodulation 3 (2), 75–81.
Baeten, C.G.M.I., 2007. Sacral nerve stimulation for fecal incontinence:
current worldwide results. Neuromodulation 10 (1), 185–186.
Barichella, M., Marczewska, A.M., Mariani, C., Landi, A., Vairo, A.,
Pezzoli, G., 2003. Body weight gain rate in patients with Parkinson’s
disease and deep brain stimulation. Mov. Disord. 18 (11), 1337–1340.
Barolat, G., Schwartzman, R.J., Aries, L., 1981. Chronic intrathecal mor-
phine infusion for intractable pain in reflex sympathetic dystrophy.
In: Proceedings of the 8th Meeting of the European Society for
Steriotatic and Functional Neurosurgery, Budapest, Hungary, p. 81.
Barolat, G., Schwartzman, R., Woo, R., 1989. Epidural SCS in the man-
agement of RSD. Stereotact. Funct. Neurosurg. 53, 29–39.
Bell, G.K., Kidd, D., North, R.B., 1997. Cost-effectiveness analysis of
SCS in treatment of failed back surgery syndrome. J. Pain Symptom
Manag. 13, 286–2985.
Bennett, D.S., Aló, K.M., Oakley, J.D., Feler, C.A., 1999. Spinal cord
stimulation for complex regional pain syndrome I [RSD]: a retro-
spective multicenter experience from 1995 to 1998 of 101 patients.
Neuromodulation 2 (3), 202–210.
Bertucci, P., 2006. Revealing sparks: John Wesley and the religious util-
ity of electrical healing. Br. J. Hist. Sci. 39, 341–362.
Biether, J.K., Cummins, S.K., Nelson, K.B., 1993. The California cerebral
palsy project. Pediatr. Perinat. Epidemiol. 6, 339–351.
Blazer, D.G., Kessler, R.C., McGonagle, K.A., Swartz, M.S., 1994. The
prevalence and distribution of major depression in a national com-
munity sample: the national comorbidity survey. Am. J. Psychiatry
151 (7), 979–986.
Boon, P., Vonck, K., DeHerdt, V., Van Dycke, A., goethals, M., Gosens, L.,
et al., 2007. Deep brain stimulation in patients with refractory tempo-
ral lobe epilepsy. Epilepsia 48 (8), 1551–1560.
Brookoff, D., 2000. Chronic pelvic pain. In: Abram, S.E., Haddox, J.D.
(Eds.), The Pain Clinic Manual. Lippincott, Williams & Wilkins,
Philadelphia, PA, pp. 239–247.
Burnett, T.A., Mann, E.A., Cornell, S.A., et al., 2003. Laryngeal elevation
achieved by neuromuscular stimulation at rest. J. Appl. Physiol. 94,
128–134.
Chae, J., Triolo, R., Kilgore, K.L., Creasey, G., DeMarco, A., 2002.
Neuromuscular electrical stimulation in spinal cord injury. In:
Kirshblum, S., Campagnola, D., DeLisa, J. (Eds.), Spinal Cord Injury
Medicine. Lippincott, Williams & Wilkins, Philadelphia.
Cigaina, V., 2002. Gastric pacing as therapy for morbid obesity: pre-
liminary results. Obes. Surg. 12 (S1), S12–S16.
Cigaina, V., 2004. Long-term follow-up of gastric stimulation for obe-
sity: the Mestre 8-year experience. Obes. Surg. 14 (S1), S14–S22.
Clinical trials.gov. http://clinicaltrials.gov/ct/show/NCT00194870;js
essionid=A35DECE1BFFC751F2818DF233494E4C8?order=9.
Coffey, R.J., Cahill, D., Steers, W., et al., 1993. Intrathecal baclofen for
intractable spaqsticity of spinal origin: results of a long-term multi-
center study. J. Neurosurg. 78, 226–232.
Creasey, G., Elefteriades, J., Dimarco, A., et al., 1996. Electrical stimula-
tion to restore respiration. J. Rehabil. Res. Dev. 33, 123–132.
Dewald, J.P.A., Given, J.D., Rymer, W.Z., 1996. Long-lasting reductions
of spasticity induced by skin electrical stimulation. IEEE Trans.
Rehabil. Eng. 4, 231–242.
Dhawan, V., Healy, D.G., Pal, S., Chaudhuri, K.R., 2006. Sleep-related
problems of Parkinson’s disease. Age Ageing 35 (3), 220–228.
Dinning, P.G., Fuentealba, S.E., Kennedy, M.L., Lubowski, D.Z., Cook,
I.J., 2007. Sacral nerve stimulation induces pan-colonic propagating
pressure waves and increases defecation frequency in patients with
slow-transit constipation. Colorectal Dis. 9 (2), 123–132.
http://en.wikipedia.org/wiki/John_Alexander_Hopps.
Fiame, D., Palombi, M., Sciacca, V., Tamori, M., 1989. SCS in peripheral
ischemia pain. PACE 12, 698–704.
Fogel, W., Krause, M., Tonnier, V., 2000. Globus pallidus stimulation in
generalized dystonia: clinical data. Mov. Disord. 15 (S3), 725.
Forster, J., Sarosiek, I., Delcore, R., Lin, Z., et al., 2001. Gastric pacing is a
new surgical treatment for gastroparesis. Am. J. Surg. 182, 676–681.
Fregni, F., Boggio, P.S., Nitsche, M.A., Marcolin, M.A., Rigonatti, S.P.,
Pascual-Leone, A., 2006. Treatment of major depression with tran-
scranial direct current stimulation. Bipolar Disord. 8 (2), 203–204.
Funkiewicz, A., Ardouin, C., Capute, E., Krack, P., Benebid, A., et al.,
2004. Long term effects of bilateral subthalamic nucleus stimulation
on cognitive function, mood, and behaviour in Parkinson’s disease.
J. Neurol. Neurosurg. Psychiatry 75, 834–839.
Gabriëls, L., Cosyns, P., Nuttin, B., Demeulemeester, H., Gybels, J.,
2003. Deep brain stimulation for treatment-refractory obsessive-
compulsive disorder: psychopathological and neuropsychological
outcome in three cases. Acta Psychiatr. Scand. 107 (4), 275–282.
Galanda, M., Horvath, S., 2003. Effect of stereotactic high-frequency
stimulation in the anterior lobe of the cerebellum in cerebral palsy:
a new suboccipital approach. Stereotact. Funct. Neurosurg. 80 (1–4),
102–107.
Galanda, M., Nodvornik, P., Fodor, S., 1980. Stereotactic approach to
therapeutic stimulation of cerebellum for spasticity. Acta Neurochir.
Suppl. 30, 345–349.
Ganio, E., Masin, A., 2000. Short-term sacral nerve stimulation for func-
tional anorectal and urinary disturbances: results in 49 patients.
Dis. Colon Rectum 43, A17.
Gildenberg, P.L., 2006. History of electrical neuromodulation for
chronic pain. Pain Med. 7 (S1), S7–S13.
Grill, W.M., Kirsch, R.F., 2000. Neuroprosthetic applications of electri-
cal stimulation. Assist. Technol. 12, 6–20.
Halstead, L.S., Seager, W.I., Houston, J.M., et al., 1993. Relief of spastic-
ity in SCI men and women using rectal probe electrostimulation.
Paraplegia 31, 715–721.
 Foreword
Harden, N., Baron, R., Janig, W., 2001. Complex regional pain syn-
drome. In: Progress in Pain Research and Management, vol. 22.
IASP Press, Seattle Washington.
Hassenbusch, S.J., Stanton-Hicks, M.D., Soukup, J., et al., 1991.
Sufentanil citrate and Morphine/Bupivacaine as alternative
agents in chronic epidural infusion for intractable non-cancer pain.
Neurosurgery 29, 76–82.
Hohenfellner, M., Humke, J., Hampel, C., et al., 2001. Chronic sacral
neuromodulation for treatment of neurogenic bladder dysfunction:
long-term results with unilateral implants. Urology 58, 887–892.
Holloway, K.L., Baron, M.S., Brown, R., Cifu, D.X., Carne, W.,
Ramakrishnan, V., 2006. Deep brain stimulation for dystonia: a
meta-analysis. Neuromodulation 9 (4), 253–261.
Hosobuchi, Y., Adams, J.E., Rutkins, B., 1973. Chronic thalamic stimu-
lation for the control of facial anesthesia dolorosas. Arch. Neurol.
29, 158–161.
Jaeger, R.J., Turba, R.M., Yarkony, G.M., Roth, E.J., 1993. Cough in spi-
nal cord injured patients: comparison of three methods to produce
cough. Arch. Phys. Med. Rehabil. 74, 1358–1361.
Kenefick, N.J., Christiansen, J., 2004. A review of sacral nerve
stimulation for the treatment of faecal incontinence.
Colorectal Dis. 6 (2), 75–80.
Kerrigan, J.F., Litt, B., Fisher, R.S., Cranstoun, S., French, J.A., Blum,
D.E., Dicher, M., et al., 2004. Electrical stimulation of the anterior
nucleus of the thalamus for the treatment of intractable epilepsy.
Epilepsia 45 (4), 346–354.
Kiely, M., Lubin, R.A., Kiely, J.Z., 1984. Descriptive epidemiology of
cerebral palsy. Public Health Rev. 12, 79–101.
Kohn, R., et al., 2004. The Treatment Gap in Mental Health Care.
The World Health Organization. http://www.who.int/bulletin/
volumes/82/11/en/858.pdf.
Krames, E.S., 1996a. The role of implantable pain management technol-
ogies: an algorithm for decision-making. In: Winnie, A., Waldman,
S. (Eds.), Interventional Pain Management. W.B. Saunders com-
pany, Philadelphia, PA, pp. 501–510.
Krames, E.S., 1996b. Intraspinal opioid therapy for chronic nonmalig-
nant pain: current practice and clinical guidelines. J. Pain Symptom
Manag. 11, 333–352.
Krames, E.S., 2001. Intraspinal analgesia for nonmalignant pain. In:
Waldman, S.D. (Ed.), Interventional Pain Management, second ed.,
pp. 609–620.
Krames, E., 2002. Best Pract. Res. Clin. Anesthesiol. 16 (4), 619–649.
Kumar, K., Toth, C., Nath, R.K., 1996. SCS is effective in RSD.
Neurosurgery 40, 503–509.
Kumar, R., Dangher, A., Hutchinson, W.D., 1999. Globus pallidus deep
brain stimulation for generalized dystonia: clinical and PET inves-
tigation. Neurology 53, 871–877.
Lance, J.W., 1980. Symposium synopsis. In: Feldman, R.G., Young,
R.R., Koella, W.P. (Eds.), Spasticity: Disordered Motor Control. Year
Book Medical Publishers, Chicago.
Landi, A., Parolin, M., Piolti, R., Antonini, A., Grimaldi, M., Crespi,
M., Iurlaro, S., Aliprandi, A., Pezzoli, G., Ferrarese, C., Gaini, S.M.,
2003. Deep brain stimulation for the treatment of Parkinson’s dis-
ease: the experience of the neurosurgical department in Monza.
Neurol. Sci. 24 (S1), S43–S44.
Latham, J., Davis, B.D., 1994. The socioeconomic impact of chronic
pain. Disabil. Rehabil. 16, 39–44.
Lezcano, E., Gómez-Esteban, J.C., Zarranz, J.J., Lambarri, I., Madoz, P.,
Bilbao, G., Pomposo, I., Garibi, J., 2004. Improvement in quality of
life in patients with advanced Parkinson’s disease following bilat-
eral deep-brain stimulation in subthalamic nucleus. Eur. J. Neurol.
11 (7), 451–454.
Liberson, W.T., Holmquest, H.J., Scot, D., et al., 1961. Functional elec-
trotherapy: stimulation of the peroneal nerve synchronized with
swing phase of gait of hemiplegic patients. Arch. Phys. Med.
Rehabil. 42, 101–105.
xxi
Lim, J., Gorman, R.B., Saboisky, J.P., Gandevia, S.C., Butler, J.E., 2005.
Electrical stimulation of human abdominal muscles. In: The 10th
International Functional Electrical Stimulation Society Conference
(IFESS).
Lim, S.-N., Lee, S.-T., Tsai, Y.-T., Chen, I.-A., Tu, P.-H., Chen, J.-L.,
Chang, H.-W., Su, Y.-C., Wu, T., 2007. Electrical stimulation of the
anterior nucleus of the thalamus for intractable epilepsy: a long-
term follow-up study. Epilepsia 48 (2), 342–347.
Lin, Z., Forster, J., Sarosiek, I., McCallum, R.W., 2003. REVIEW: treat-
ment of gastroparesis with electrical stimulation. Dig. Dis. Sci. 48 (5),
837–848.
Linderoth, B., Foreman, R.D., 2006. Mechanisms of SCS in painful syn-
dromes: role of animal models. Pain Med. 7 (S1), S14–S26.
Ludlow, C.L., Humbert, I.J., Poletto, C.J., Saxon, K.G.G., Kearney, P.R.,
Crujido, L., Sonies, B., 2005. The use of coordination training for
the onset of intramuscular stimulation in dysphagia. In: The 10th
International Functional Electrical Stimulation Society Conference
(IFESS).
Lynch, S.S., 2006. Intrathecal ziconotide for refractory chronic pain.
Ann. Pharmacother. 40 (7), 1293–1300.
Macres, S., Richeimer, S., 2000. Successful treatment of erythromelal-
gia with intrathecal hydromorphone and clonidine. Clin. J. Pain 16,
310–313.
Mannheimer, C., Eliasson, T., Anderson, B., et al., 1993. Effects of SCS
in angina pectoris induced by pacing and possible mechanisms of
action. Dr. Med. J. 307, 477–480.
Mayberg, H., Lozano, A., Voon, V., McNeely, H., Seminowicz, D.,
Hamani, C., Schwalb, J., Kennedy, S., 2001. Deep brain stimulation
for treatment resistant depression. Neuron 45 (5), 651–660.
Maynard, F.M., Karunas, R.S., Waring, W.P., 1990. Epidemiology of
spasticity following traumatic spinal cord injury. Arch. Phys. Med.
Rehabil. 71 (8), 566–569.
Mazzone, P., Brown, P., DiLazzaro, V., Stanzione, P., Oliviero,
A., Peppe, A., Santilli, V., Insola, A., Altibrandi, M., 2005.
Bilateral implantation in globus pallidus internus and subthalamic
nucleus in Parkinson’s disease. Neuromodulation 8 (1), 1–6.
Mazzone, P., Stocchi, F., Galati, S., Insola, A., Maria Grazia Altibrandi,
M.G., et al., 2006. Bilateral implantation of centromedian-­
parafascicularis complex and GPi: a new combination of
unconventional targets for deep brain stimulation in severe
­
Parkinson disease. Neuromodulation 9 (3), 221–228.
Medtech Insights. http://www.medtechinsight.com/Report1407.
html.
Meloy, T.S., Southern, J.P., 2006. Neurally augmented sexual function
in human females: a preliminary investigation. Neuromodulation
9 (1), 34–40.
Melzack, R.A., Wall, P.D., 1965. Pain mechanisms: a new theory. Science
150, 971–979.
Müller-Schwefe, G., Hassenbusch, S.J., Reig, E., 1999. Cost-
effectiveness of intrathecal therapy for pain. Neuromodulation 2
(2), 77–84.
http://muse.jhu.edu/login?uri=/journals/philosophy_psychiatry_
and_psychology/v008/8.2davies.html.
Mysiw, W.J., Jackson, R.D., 2000. Electrical stimulation. In: Braddom, R.
(Ed.), Physical Medicine and Rehabilititation. W.B. Saunders com-
pany, Philadelphia.
Nienke, C., Vulink, et al., 1999. The effects of SCS on quality of life
in patients with therapeutically chronic refractory angina pectoris.
Neuromodulation 2 (1), 33–40.
Nilsson, M.H., Tornqvist, A.L., Rehncrona, S., 2005. Deep-brain stimu-
lation in the subthalamic nuclei improves balance performance
in patients with Parkinson’s disease, when tested without anti-­
parkinsonian medication. Acta Neurol. Scand. 111, 301–308.
Nitescu, P., Sjoberg, M., Applegren, L., et al., 1995. Complications of
intrathecal opioids and bupivacaine in the treatment of refractory
cancer pain. Clin. J. Pain 11, 45–62.
xxii Foreword
North, R.B., Kidd, D.H., Zahurak, M., James, C.S., Long, D.M., 1993.
SCS for chronic intractable pain. experience over two decades.
Neurosurgery 32, 384–394.
North, R.B., Kidd, D.H., Piantadosi, S., 1995. SCS versus reoperation
for failed back surgery syndrome: prospective, randomize study
design. Acta Neurochir. Suppl. 64, 106–108.
Obeso, J.A., et al., 2001. The deep brain stimulation for parkinson’s
disease study group. DBS of the subthalamic nucleus or the pars
interna of the globus pallidus in Parkinson’s disease. N. Engl. J.
Med. 345 (13), 956–963.
Oh, M.Y., Ortega, J., Bellotte, J.B., Whiting, D.M., Aló, K., 2004.
Peripheral nerve stimulation for the treatment of occipital neural-
gia and transformed migraine using a C1-2-3 subcutaneous paddle
style electrode: a technical report. Neuromodulation 7 (2), 103–112.
Osorio, I., Overman, J., Giftakis, J., Wilkinson, S.B., 2007. High fre-
quency thalamic stimulation for inoperable mesial temporal epi-
lepsy. Epilepsia 48 (8), 1561–1571.
Palombi, M., Bartoli, S., Altibrandi, M.G., Leporelli, P., Mazzone, P.,
2002. Spinal cord stimulation in lower limb critical limb ischaemia:
indications and results. First Rome symposium on neuromodula-
tion, the Rome group of neuromodulation on behalf of the Italian
chapter of the INS. Neuromodulation 6 (3), 190–217.
Pinter, M.M., Gerstenbrand, F., Dimitrijevic, M.R., 2000. Epidural elec-
trical stimulation of posterior structures of the human lumbosacral
cord: control of spasticity. Spinal Cord 38 (9), 524–531.
Popeney, C.A., Alo, K.M., 2003. Peripheral neurostimulation for the
treatment of chronic, disabling transformed migraine. Headache
43, 369–375.
Popovic, D.B., Popovic, M.B., Sinkjær, T., 2002. Neurorehabilitation
of upper extremities in humans with sensory-motor impairment.
Neuromodulation 5 (1), 54–66.
Privitera, M.D., Welty, T.E., Ficker, D.M., Welge, J., 2002. Vagus nerve
stimulation for partial seizures. Cochrane Database of Syst. Rev. (1).
Putnam, K., McKibbin, L., 2004. Managing workplace depression:
an untapped opportunity for occupational health professionals.
AAOHN J. 52 (3), 122–129.
Electroencephalography (EEG) and deep brain stimulation (DBS)
in epilepsy. http://www.responsivehealth.com/ClinicalTrial/
Electroencephalography-and-Deep-Brain-Stimulation.aspx.
Rodriguez, M., 1989. Basic concepts and hypothesis in multiple sclero-
sis. Mayo Clin. Proc. 64, 570–576.
Romito, L.M.A., Scerrati, M., Contarino, F., et al., 2002. Long-term fol-
low-up of subthalamic nucleus stimulation in Parkinson’s disease.
Neurology 58, 1546–1550.
Romito, L.M., Franzini, A., Perani, D., Carella, F., Marras, C., Capus, L.,
Garibotto, V., Broggi, G., Albanese, A., 2007. Fixed dystonia unre-
sponsive to pallidal stimulation improved by motor cortex stimula-
tion. Neurology 68 (11), 875–876.
Sackeim, H.A., Rush, A.J., George, M.S., Marangell, L.B., Husain,
M.M., et al., 2001. Vagus nerve stimulation (VNS™) for treatment-
resistant depression: efficacy, side effects, and predictors of out-
come. Neuropsychopharmacology 25 (5), 714–728.
Sanderson, J.E., Brooksby, P., Waterhouse, D., Palmer, R.B.G.,
Neubauer, K., 1992. Epidural SCS for severe angina: a study of its
effects on symptoms, exercise tolerance and the degree of ischemia.
Eur. Heart J. 13, 628–633.
Scerraati, M., Iacoangeli, M., Ricciuti, R., Rychlicki, F., 2003. Surgical
treatment for Parkinson’s disease: from sterotactic ablative proce-
dures to chronic high frequency DBS. First Rome symposium on
Neuromodulation, the Rome group of neuromodulation on behalf
of the Italian chapter of the INS. Neuromodulation 6 (3), 217.
Schrag, A., Ben-Shlome, Y., Quinn, N.P., 2000. Cross sectional preva-
lence survey of idiopathic Parkinson’s disease and parkinsonism in
London. BMJ 321, 21–22.
Schuchard, M., Krames, E.S., Lanning, R.M., 1998. Intraspinal anal-
gesia for nonmalignant pain: a retrospective analysis for efficacy,
safety and feasibility in 50 patients. Neuromodulation 1, 46–56.
Schwedt, T.J., Dodick, D.W., Hentz, J., Trentman, T.L., Zimmerman,
R.S., 2007. Occipital nerve stimulation for chronic headache—long-
term safety and efficacy. Cephalalgia 27, 153–157.
Segal, R., Stacey, B.R., Rudy, T.E., Baser, S., Markham, J., 1998. SCS
revisited. Neural Res. 20, 391–396.
Sevcencu, C.A., 2007. Review of electrical stimulation to treat motility
dysfunctions in the digestive tract: effects and stimulation patterns.
Neuromodulation 10 (1), 85–99.
Shealy, C.N., Mortimer, J.T., Reswick, J., 1967. Electrical inhibition
of pain by stimulation of the dorsal column: preliminary clinical
reports. Anesth. Analg. 46, 489–491.
Siegfried, J., lazorthes, Y., Broggi, G., 1981. Electrical SCS for spastic
movement disorders. Appl. Neurophysiol. 44 (1–3), 77–92.
Spinal Cord Information Network. http://www.spinalcord.uab.edu/
show.asp?durki=21446.
Stanton-Hicks, M., 1999. SCS for the management of the complex
regional pain syndrome. Neuromodulation 2 (3), 193–201.
Stillings, D., 1971. The First Use of Electricity for Pain Treatment,
Medtronic Archive on Electrostimulation.
Tiede, J.M., Huntoon, M.A., 2004. Review of SCS in PAD (peripheral
arterial disease). Neuromodulation 7 (3), 168–175.
Troyk, P.R., Donaldson, N.D., 2001. Implantable FES stimulation sys-
tems: what is needed? Neuromodulation 4, 196–204.
Twelves, D., et al., 2003. Systematic review of incidence studies in
Parkinson’s Disease. Mov. Disord. 18, 19–31.
Van Buyten, J.P., 1998. Outcomes of intrathecal morphine. In: Presented
at: Advanced Interventional Pain Therapies Meeting, European
Continuing Medical Training Symposium; May 1998; Tenerife, Spain.
van der Pal, F., van Balken, M.R., Heesakkers, J.P.F.A., Debruyne,
F.M.J., Bemelmans, B.L.H., 2006. Implant-driven tibial nerve stimu-
lation in the treatment of refractory overactive bladder syndrome:
12-month follow-up. Neuromodulation 9 (2), 163–171.
Velasco, F., Velasco, M., Velasco, A.L., Jimenez, F., Marquez, I., Rise, M.,
1995. Electrical stimulation of the centromedian thalamic nucleus in
control of seizures: long-term studies. Epilepsia 36 (1), 63–71.
Ventafrida, V., Figliuzzi, M., Tamburini, M., et al., 1979. Clinical obser-
vation on analgesia elicited by intrathecal morphine in cancer
patients. In: Bonica, J.J., Ventafrida, V. (Eds.), Advances in Pain
Research and Therapy, vol. 2. Raven, New York, pp. 559–565.
Vilensky, J.A., Gilman, S., 2002. Horsley was the first to use electrical
stimulation of the human cerebral cortex intraoperatively. Surg.
Neurol. 58, 425–426.
Walker, R.H., Danisi, F.O., Swope, D.M., Goodman, R.R., Germane,
I.M., 2000. Intrathecal baclofen for dystonia: benefits and com-
plications during six years of experience. Mov. Disord. 15 (6),
1242–1247.
Waltz, J.M., Reynolds, L.O., Riklan M., 1981. Multi-lead spinal cord
stimulation for control of motor disorders stereotactic and func-
tional neurosurgery. 44, 244–257.
Wang, J.F., Nauss, L.A., Thomas, J.E., 1979. Pain relief by intrathecally
applied morphine in man. Anesthesiology 50, 149–151.
Weiner, R.L., Reed, K.L., 1999. Peripheral neurostimulation for the
control of intractable occipital neuralgia. Neuromodulation 2,
369–375.
Wilson, J.A., Smith, R.G., 1989. The prevalence and aetiology of long-
term L-Dopa side-effects in elderly Parkinsonian patients. Age
Ageing 18, 11–16.
Winkelmuller, M., Winkelmuller, W., 1996. Long term effect of continu-
ous intrathecal opioid treatment in chronic pain of nonmalignant
etiology. J. Neurosurg. 85, 458–467.
WrongDiagnosis.Com. http://www.wrongdiagnosis.com/s/stroke/
prevalence.htm#abstop.
Wynn, D.R., Rodriguez, M., O’Fallon, W., 1989. Update on the epidemi-
ology of MS. Mayo Clin. Proc. 64, 808–817.
 S E C T I O N
DEFINING NEUROMODULATION
Elliot S. Krames1, Ali R. Rezai2, P. Hunter Peckham3
1Pacific Pain Treatment Center, San Francisco, CA, United States; 2West Virginia University, Morgantown,
WV, United States; 3Case Western Reserve University, Cleveland, OH, United States
INTRODUCTION
Neuromodulation as defined by the International
Neuromodulation Society (INS) is “a field of sci-
ence, medicine, and bioengineering that encompasses
implantable and non-implantable technologies, electri-
cal or chemical, for the purpose of improving the life
of humanity.” It is technology at the interface to neural
tissue. This Textbook of Neuromodulation, Second
Editon is devoted to the expanding field of neuromodu-
lation and an expansion of the first edition, published in
2009. This second edition is divided into three volumes,
with a total of 16 sections and 144 chapters. Section I
of this book defines the field and considers thoughts,
understandings, and key questions in the field. Though
not based on the rigorous bibliographical research of the
rest of this textbook, this introductory section to the field
is intended to introduce the breadth and depth of the
field of neuromodulation before delving into the heart
of the text.
Chapter 1 of these introductory chapters, “Defining
Neuromodulation,” written by Drs. Krames, Rezai, and
Peckham, is a foreword to the rest of the textbook. In this
chapter, the authors define neuromodulation as distinct but
inclusive of prior terms which include neurostimulation,
1
I
functional electrical stimulation, neural prosthetics, brain–
machine interface, intrathecal and intraventricular drug
delivery systems, among others. The authors set the tone
for the new and exciting field of neuromodulation by
defining populations of patients who might require these
devices (the market) and discuss by disease process what
is known about the disease and how devices may and do
improve patients with the disease. Subsequent chapters
of this section on an introduction to neuromodulation
include the following chapters:
1. P erspectives on the History of Neuromodulation-
Relevant Societies, by Elliot S. Krames, Konstantin
V. Slavin, Giancarlo Barolat, Brian Simpson, and
Michael Stanton-Hicks
2. Psychological Issues and Evaluation for Patients
Undergoing Implantable Technology, by Daniel M.
Doleys and Jeffery J. Dolce
3. Anatomy of the Nervous System, by Joshua M.
Rosenow
4. Clinical Study Designs for Neuromodulation, by
Richard B. North and Jane Shipley
  
These introductory chapters are intended to set the
stage for the rest of this second edition.
Another random document with
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words, the Soudan has cost Egypt nominally about £600,000 a year
for the last five years.
But as a matter of fact the real cost during the five years has been
a good deal less than this. Various deductions ought to be made. In
the first place, Egypt takes all the Custom duties on goods going
through to the Soudan. These came to about £60,000 in 1902, and
were estimated at about £70,000 for 1903, an estimate very likely to
be below the mark. It is safe to reckon that during the five years they
amounted to nearly £200,000. Then, the expenses of the Egyptian
army of occupation in the Soudan are charged to the Soudan
Government. During the first two years these amounted to about
£300,000 per annum. Taking an average of £200,000, we get a sum
of £1,000,000 under this head. If the Soudan had not been
reconquered, Egypt would have had to maintain nearly as large an
army as at present, and although the cost of maintenance is
naturally larger in the Soudan, it would not be unfair to deduct
another £800,000 as money that must have been expended in any
case. Of the capital expenditure, £600,000 was in loans for railway
and telegraph development. Although the prospect of repayment of
these loans is somewhat remote, they ought not to be written off as
pure out-of-pocket expenses, seeing that the Soudan Government
pays 2½ per cent. per annum upon them. Two and a half per cent.
on £600,000 is equal to 5 per cent. on £300,000. An investment with
this return would be more advantageous to Egypt than extinguishing
an equal portion of her debt, and it is therefore reasonable to deduct
that sum from the total expenditure. All these allowances added
together make up a sum of £1,300,000, bringing the average annual
cost to Egypt during the five years down to £340,000; while in
addition to all this the Egyptian revenues have also directly benefited
through the Railways and Post-office by the extra passengers,
goods, letters, telegrams, and money orders, passing to and fro.
Still, when all deductions have been made, it cannot be denied,
especially as the Soudan still calls loudly for more capital
expenditure, that the reoccupation of that country, from a strictly
financial point of view, though in one aspect philanthropic, is not as
yet philanthropy at 5 per cent. But there are certain solid advantages
which, though their value to Egypt is difficult to calculate in terms of
money, are worth to her many times over the actual sum which the
Soudan costs her.
First of all comes the fact, so often insisted upon, that the whole of
the upper waters of the Nile are now in the secure possession of
those who are responsible for her welfare. This supreme and vital
necessity overshadows all others, and would by itself have forced
her to undertake almost any sacrifice. In fact, as all the water in
Egypt comes through the Soudan, her contribution may be looked
upon as a water-rate calculated at an exceedingly low figure.
Secondly, she is relieved from all fear of foreign invasion. The
frontier is once more at rest, and no longer troubled even by raids.
There is a vast difference between a peaceful and comparatively
prosperous neighbour and a horde of furious barbarians hammering
at her gates.
Further, the pacification of the Soudan enabled the burden of
conscription to be diminished. The army was reduced by 5,500 men,
and the period of service was reduced from fifteen years to ten, of
which five have to be spent with the colours, and five in the reserve
or police. Considering how much the Egyptian fellah dislikes military
service, those who are affected by this change probably regard it as
the greatest benefit of all.
A new field has also been opened for Egyptian trade and the
employment of Egyptians. A constantly expanding market at her
door for sugar and other goods is no small advantage. A good deal
of the money spent in the Soudan, though lost to the Egyptian
Treasury, is not lost to Egypt, for it takes the form of salaries for
numbers of Egyptians in the Government service, and the money
orders passing from the Soudan to Egypt show that at least a portion
of it returns immediately. Moreover, the Soudan is gradually losing its
old traditional terrors, and more and more Egyptians, though as yet
in small numbers, are returning to settle there when their period of
service is over.
Lastly, the good name of Egypt has been restored; one of the evil
pages in her history has been finally turned. The country which she
once ruined by her misgovernment and oppression and by her
greedy haste to share in the profits of the slave-trade, and then
abandoned to barbarism, has been rescued, and set moving once
more on the paths of civilization and good government. It is right that
in the days of her prosperity she should do something to assist her
less fortunate neighbour.
It has been said that for the present Egypt will continue her annual
grant to the Soudan of £E390,000 a year. But she will also be called
upon to find some large additional sums. The Soudan requires
capital, but has no credit of her own on which to borrow. The British
taxpayer ought not to be called upon, even if he had not borne his
share already, since it is not his interests, but those of Egypt, which
are primarily concerned. But Egypt herself is not in a position, owing
to international complications, to contract new loans, nor is it at all
desirable to impose additional taxation for the purpose. Private
enterprise, even if it was possible to employ it, would in the end be
too expensive. But the problem is not insoluble, though difficult. Lord
Cromer in his last report gives a most admirable summary of the
position:

‘I hope and believe that, although the difficulties are considerable, they will not
prove insurmountable. A hopeful feature of the future is to be found in the fact, on
which I have dwelt at some length in my Egyptian Report, that the programme of
fiscal reform in Egypt is now completed. It cannot be doubted that the people of
Egypt are now very lightly taxed. Strongly as I should object to any increase of
Egyptian taxation for Soudanese purposes, I can see no objection whatever to
maintaining such taxes as at present exist, partly with a view to providing the
capital necessary for the improvement of the Soudan. Indeed, far from there being
any objection, I believe the adoption of such a course to be strictly in accordance
with Egyptian interests; for, until capital is spent, the Egyptian Treasury cannot
hope that any considerable reduction in the present Soudan deficit will be possible.
I am, of course, aware that the purely Egyptian requirements, such as improved
justice and police, to which allusion is made in my Egyptian Report, must, in this
connection, take precedence of the necessities of the Soudan, great though these
latter be. I am, however, not without hope that, if due care and deliberation be
exercised, if the projects on which capital is spent be chosen after a thorough
examination of their merits and practicability, and if everything in the nature of
undue haste and precipitation be avoided, money in fairly adequate quantities may
eventually be found both for the improvement of the Egyptian administrative
services and for the development of the Soudan.
‘There can be no question as to the direction in which capital expenditure is
most required. As I have said in my Egyptian Report, the construction of the
Suakin-Berber Railway is absolutely essential to the well-being of the Soudan. I
need only add that all the testimony which I received during my recent visit to the
Soudan strongly confirmed me in the opinion which I had previously held on this
subject.’

Such words coming from Lord Cromer are full of hope and
encouragement for the administrators of the Soudan. The man who
found means to overcome the financial difficulties of the Reservoir
works at Assouan is more than likely to surmount those of the
Suakin-Berber Railway.
In the long-run Egypt herself will benefit as well as the Soudan. Of
course, most of the trade now passing through Egypt will return to its
natural channel by Suakin and the Red Sea. The Customs now
taken at Alexandria will go directly to the Soudan, but as soon as this
happens a corresponding reduction can be made in the Egyptian
contribution. Nor will purely Egyptian trade with the Soudan suffer.
The Nile Valley route will remain, but it will be cheaper for goods
from Lower Egypt to travel via Suez and Suakin. The import as well
as the export trade of the Soudan will be vastly encouraged, and
every step forward in prosperity will make her a better market for the
goods of Egypt as well as those of other countries. Once the railway
is made, but not till then, there is a possibility of the revenues of the
Soudan improving sufficiently to make the country self-supporting,
and able to dispense entirely with any annual grant from Egypt.
It is calculated that the construction of the new railway will cost
£2,500,000. Taking this as a basis, and assuming that Egypt was
able to make an arrangement under which the money should be
repaid by annual instalments over a period of ten years, with interest
at 5 per cent., it would involve an average annual addition to her
expenditure of £318,750, or a total cost of ten times that sum. If the
period was twenty years, the average annual cost would be
£185,625, or, say, £200,000. It is rash for an outsider to speculate on
such subjects, and the figures are merely given as a rough
illustration; but it seems certain that Egypt could easily bear any
such burden. Nor does it appear a sanguine forecast to estimate that
within ten years of the completion of the railway the revenues of the
Soudan will have so greatly benefited, both by the direct cheapening
of supplies, fuel, and other material, and by the development of trade
generally, that at least a saving of £200,000 a year will accrue to
Egypt, even if she still finds it prudent to contribute something.
What future capital Egypt will have to find must be uncertain. The
whole situation will be changed by the advent of the railway. But if all
the signs of the times can be trusted, whatever her expenditure may
be, she will have no reason to repent of it.

Note.—Since the above was in print, new light has been thrown on the subject
by a passage in the Note on the Budget for 1904 by Sir Eldon Gorst, Financial
Adviser to the Khedive:
‘The Council of Ministers has authorized the Ministry of Finance to advance out
of the Special Reserve Fund the amount required for the construction of a railway
to connect the Valley of the Upper Nile near Berber with the Red Sea at Suakin.
The preliminary survey of the proposed line has been completed, and an estimate
of its cost prepared. The total sum required, which amounts to about £E1,770,000,
will be spread over a period of from three to four years, so that there should be no
difficulty in meeting the charge out of the annual increment of the Special Reserve
Fund, but it will be obviously undesirable to sanction any further large grants out of
the fund during this period. The construction of the railway will be put in hand
without delay, and if no unforeseen contingency occurs, it may be hoped that it will
be available for traffic in about three years’ time.’
The Special Reserve Fund is made up of the free balance remaining at the
disposal of the Egyptian Government when all other claims on their receipts have
been settled.
 CHAPTER XXIII
CONCLUSION

Some time ago a small detachment of Egyptian troops was passing

through a village in a remote and primitive part of Kordofan. A soldier
of the party, going to draw water at the well, there met, like Jacob,
one of the daughters of the people, who helped him in his task. Out
of gratitude for her assistance or admiration for her charms, he gave
her one of the few things he had to offer, a large red cotton
handkerchief. Attired in it, the damsel excited the admiration and
envy of all her fellows, and from this chance seed arose a demand
for Manchester cotton goods. But as the desired articles could not be
purchased for nothing, the supply of charitable soldiers being limited,
the inhabitants had to apply themselves to the collection of gum in
order to be able to satisfy their wants. And thus the exports improved
as well as the imports.
In different forms the same process is going on all over the
Soudan, and the sternest admirer of Arcadian simplicity could hardly
deny that the people are happier and better because of it. The
country is not such an El Dorado that they are likely to be corrupted
by excessive wealth. Their awakening needs can only be satisfied by
means of habits of industry. Thanks to good government they are
able on the one hand securely to enjoy the fruits of their labour, and
on the other hand, they are prevented from taking any short-cuts to
fortune by raiding their neighbours and selling them into slavery.
If it were necessary to justify British interference in the Soudan,
the fact of the repression of slavery would alone be sufficient. If the
slave-trade does still exist, it does so only precariously in a few
remote holes and corners. The markets of Khartoum and Omdurman
and other centres are greater and more various than they have ever
been before, but this one traffic, once their principal feature, is
absent and gone for ever. No change could be greater or eventually
more beneficial in its effects on the whole life and character alike of
the slave-owners, the slave-dealers, and those unhappy tribes who
involuntarily furnished their material.
The establishment of personal liberty and of security for life and
property, elsewhere the commonplaces of government, is not always
the result of civilization in Africa. They are new, at any rate, in the
Soudan. But it would ill become the English rulers of the Soudan to
take any credit to themselves if their five years’ record had no more
to show than this. They must not be content to be judged by
comparison with any former rulers. After the Khalifa’s tyranny, almost
any government would seem mild and beneficent. It is not enough
merely to have stanched the wounds by which the patient was
bleeding to death; the foundations must be laid for his complete
restoration to health and vigour. Judged by this test, however, they
need not fear the verdict.
The chief difficulty is the universal ignorance and superstition that
prevail. But these ancient fortresses are being directly assaulted
every day by the extension of a sound system of education. The
strong administration of equal justice, and the increasing growth of
trade and commerce, work powerfully in the same direction. All three
agents are stimulated by the improvement of communications by
river, road, and railway. There is hope in the fact that, though the
people start from a very low level, their past has not been one of
complete barbarism. Although Egyptian and dervish rule repressed
all habits of industry and culture, the people of the country which was
once the kingdom of Sennar had considerable repute as weavers,
goldsmiths, curriers, and potters. They still practise a native form of
inoculation for small-pox. And, to take their traditions still further
back, it is said that in some places, in the elaborate dressing of their
hair and the use of ornamental sandals on great occasions, they
reproduce the fashions of ancient Egypt. Ed Damer, near the
junction of the Atbara and the Nile, now a paltry village, had once a
university of its own no less than Sennar.
Time, of course, must be allowed for these influences to work. Not
in five years and not in one generation can the evils deep-rooted in
the past be swept away. Though all the reforms have been
introduced most cautiously, and with great regard for the prejudices
and traditions of the people, it is still sometimes necessary to teach a
sharper lesson, and to clearly advertise the fact that if the
Government is benign and merciful it is not because it is weak.
When such occasions do arise, as in the case of the last in the
succession of Mahdis, suppressed a few months ago in Southern
Kordofan, there is no fumbling and delay. The blow is struck at once
and decisively. There is a wonderful difference between a prophet
with a divine mission to regenerate Islam by force of arms
slaughtering a rabble of ill-led Egyptian peasants, and an impostor
unable to free himself from prison, or dangling from a gallows in El
Obeid after being captured in the field and fairly tried with all the
forms of law.
Such incidents, when properly handled, are only ripples on the
general calm. There have been rumours from time to time of troubles
likely to arise from the action of the Sheikh-es-Senussi. There were
internal troubles in the kingdom of Wadai, which lies to the west of
Darfur, and it was thought that these might force him to abandon his
peaceful attitude, for his influence is predominant in that country. It
would undoubtedly be dangerous if he were to proclaim a holy war,
for he has many adherents in the Soudan as well as in Egypt. But
until now his sect has been founded on rules of conduct, and he and
his predecessors have steadily refused to adopt a militant attitude.
The Mahdi was a good deal afraid of him, and nominated him as one
of his Khalifas, but he refused to accept the position. It is now
announced that the French have occupied Wadai; we have every
reason to welcome them as neighbours. Wadai was one of the few
remaining strongholds of the slave-trade, and its suppression there
will facilitate the operations of the Slavery Department in Western
Kordofan. And should any trouble arise from the followers of the
Sheikh-es-Senussi or any other sect in that quarter, it will be a great
advantage to have the co-operation of the French, who would have
the same interest as ourselves in speedily putting it down. On the
other side, now that the frontier is settled, there is not likely to be
trouble with the Abyssinians, and the Italians in Eritrea and
Massowah are the best of neighbours.
 It may some day be necessary to interfere in Darfur, though not
during the reign of the present Sultan, Ali Dinar. Ali Dinar has seen
something of the world; he is a vigorous ruler, and he understands
very plainly that his interests lie in keeping on good terms with the
Soudan Government. But some day Ali Dinar will be gathered to his
fathers, and possibly some Rehoboam will succeed him, who will
cause internal dissensions, or someone afflicted with Napoleonic
ideas, who will have to be chastised. Sooner or later, something of
the kind is bound to happen, but it is to be hoped that a country so
remote from the Nile will continue under its native rulers as long as
possible.
What the future political status of the Soudan will be depends
upon the course of events in Egypt. As long as Lord Cromer is there
—and long may it be—everyone may feel easy. But when some
lesser man has to stand as buffer between Egypt and the Foreign
Office, it may make a great difference whether Egypt takes her place
as definitely a part of the British Empire or not. Every year the
number of British civilians in the Soudan service is growing. Great as
have been the services of the officers of the Egyptian army, their
employment has this disadvantage, that they are liable to be called
away just when they are most required, and when they have
thoroughly learned the business of administration. It has been good
for the Soudan to have the choice of some of the most capable
officers in the British Army for her civil work, and a spell of civil
administration is excellent training for the soldier. But a glance at the
names of the governors and inspectors of provinces year by year
shows what a number of changes there are under the system. Some
of them will probably throw in their lot definitely with the Soudan; but
this can only be counted upon in exceptional cases. As
administration becomes more complicated, it will be less possible for
the soldier to take up the reins as he can now. Specially trained men
will be more and more necessary. But at present the Soudan civil
service is a water-tight compartment. Its members are in a doubtful
sort of position. They are not in the Egyptian service, nor in the
British Colonial Service, nor are they definitely under the Foreign
Office. Up till now there has been no difficulty in recruiting the small
number of capable civilians required. But as the number increases
there may be some difficulty in obtaining sufficient candidates of the
right stamp. Unless the country becomes very much more wealthy, it
has no great prizes to offer. But if the whole Nile Valley were in
practice regarded as one country, which it really is, and all under one
head, with one combined civil service, there would be much more
scope for able men, and each part of it would benefit by the
possibilities of interchange.
It would be a great piece of organization; but, with Indian
experience before us, there is no reason why it should not be a
success. Direct administration ought not to be in the hands of the
Foreign Office, which has plenty of diplomatic business of its own to
look after. In one department, and that a very important one, the
whole of Nileland will, indeed, be so organized in practice. When the
great schemes for the final binding of the Nile are put in hand, they
must be all under one control, and that control will be exercised from
Cairo. It would be intolerable and impossible that every time it was
thought desirable to open the Reservoir gates, say of Lake Albert,
there should have to be negotiations between district governments
or departments. The water of the Nile has made its powerful political
influence felt throughout the Soudan; in time it will play its part in
Uganda.
But such semi-continental speculations are unprofitable except for
those who have some power to realize them. For the present the
horizon of Soudan politics is bounded by the railway. From its
completion all immediate plans of progress must take their start. It
would be foolish to take too sanguine a view. Railway
communication between Khartoum and the Red Sea will not smooth
away all the difficulties of administration. There will still be years of
low Nile and scanty rainfall. There will still be an abominable climate
during a large portion of the year. Mosquitoes, sand-flies, and other
insects will still ply their uncomfortable occupations. Dhurra will still
suffer from curious and unique parasites. Cattle will be subject to
murrain. Perhaps cotton, free from ‘worm’ and ‘hog,’ will discover
some new foe to combat. Locusts and white ants will still
occasionally devour what they ought not, and possibly develop fresh
objectionable tastes. New Mahdis, unconvinced by the doom of their
predecessors, may still require to be put down from time to time.
Economic laws cannot be expected to work with the same certainty
and freedom from cross-currents as they do in Egypt. In other words,
the Soudan is a tropical country, subject to surprises: it will have its
ups and downs like other places. These and similar difficulties it
would have to face, railway or no railway. But beyond question, once
the line is open, it will be in a far better position to grapple with them
all, and to reap the benefits of the sound foundations which are now
being solidly and patiently laid by the handful of Englishmen to
whose charge its destinies have been entrusted by Fate. And
whatever else of good or evil the future may have in store, the
Soudan has one treasure which makes it certain that it will never
again be allowed to lapse from the pale of civilization, and that is not
the gold which attracted the attention of its former invaders, with
such disastrous consequences both to conquerors and conquered,
but the inestimable possession of the Nile.
 INDEX

Abbas Pasha, 30
Abd-el-Kader, 160
Abd-el-Rahman the Just, 151
Abu Hamed, 168, 175, 176, 229
Abu Simbel, temple of, 174
Abu Zeid, 125
Abyssinia:
Bonchamps Expedition from, 170
coffee from, 239, 241
Egypt—
annexations by, 153
defeat by, 144
defeat of, 154
frontier settlement with, 193, 232, 274
gold district in, 245
Gordon’s arrangement with, 155
Khalifa at war with, 166
Nile, treaty regarding (1902), 113
scenery and climate on frontier of, 189
Sennar triumph over, 140, 141
slave-raiding on frontier of, 211
trade with—
cotton in demand for, 242
railway suggested to open up, 232
Sobat as route for, 233
Achmet Bey, 143
Acre, 24, 28
Adlan, King, 140, 144
Agricultural Banks, 105, 234
Ahmed Hamad, 207
Aird and Co., 81
Akobo River, 187
Albert Edward Lake, 121
Albert Nyanza:
Baker’s discovery of, 149
circumnavigation of, 151, 157
dam on, scheme for, 118-123
regulator at, suggestion of, 132, 133
Alexandria, journey from, to Khartoum, 173-177
Ali Dinar, Sultan of Darfur, 190, 192, 193, 274
Amara Dunkas, 140
Ambadi, Lake, 126
American Medical Mission, 223
Angarebs, 182
‘Antiquos,’ 182
Arabia, slave demand in, 212
Arabic, 198, 224
Arabs:
as engineers, 29
characteristics of, 223, 225
intermixture with negroes, 140
misrule by, 19
slave-trade carried on by, 140, 142
Soudanese settlements of (A.D. 700), 139
Training College for, 204, 222, 223
views on slavery, 213
Ardrup, 154
Argin, 166
Assiout Barrage:
beneficial effect of, 89
construction of, 85, 86
cost of, 88, 89
Assouan:
granite outcrop at, 73, 81, 93; quarries, 93, 94
journey to, from Luxor, 174
maximum flood at, variations in, 11
 Nile discharges at, 6-10, 75, 89
prosperity of, 91
‘red’ water at, 8
site of, 92
Assouan Dam:
appearance of, 95-98
Barrage in relation to, 28
beneficial effects of, 82-84
compensation cases arising from, 103, 104
construction of—
difficulties of, 82
numbers employed in, 82
time allowed for, 81
cost of, 88
dimensions of, 82
distribution of water stored by, 82, 83, 85
financial arrangements regarding, 79, 84
inauguration of, 92, 98-102
locks on west side of, 82, 96
nature of, 74, 75
Philæ champions’ effect on, 76
suggestion of, 72, 73
volume of water to be provided by, if raised to full height, 114
Atbara, Battle of the, 168, 176
Atbara River:
basin irrigation on, suggested, 236
disappearance of, 6, 10
flood-water on, date of, 8
intercepting of, suggested, 133
junction of, with Nile, 5
railway to cross, project of, 230
soil in district of, 189
Austrian R.C. Mission, 223
Azande (Niam-Niams), 145, 194

Baadi, King, 140, 141

Babu class non-existent, 224
Baggara tribes, 190
Bahr el Gebel. See Nile, White
Bahr el Ghazal:
Kitchener’s gunboats on, 168
sudd in, 126, 131
waste of, 5, 124, 125
Bahr el Ghazal Province:
finances of, 259
French advance into, 169, 170
Gessi’s exploits in, 157
iron in, 244
nature of country, 189
rubber from, 239, 244
situation of, 191
slave-trade in, 145, 150
Suleiman’s revolt in, 156
tribes in, 194
waterways in, 189, 233
Bahr el Homr, 169
Bahr el Zeraf. See under Nile
Bahr Yusuf, 29, 31, 85
Baker, Sir Benjamin, 70
Baker, Sir Samuel: dam suggested by (1867), 73; travels of (1863 and 1870),
128; Ismail’s employment of, 148, 149
Baker, Valentine, 164
Baksheesh, 103
Bari tribe, 180
Baring, Sir E. See Cromer
Baro River, 187
Barrage, nature of, 46. See also Damietta and Rosetta
Barun negroes, 211
Basin irrigation. See under Irrigation
Belgians, advance of, 169
Lado Enclave leased to, 188
Beni Gerrar, 190
Beni Omr, 139
Beni Shangul, 142, 245
Berber:
colony at, a failure, 227
fakir suspected of murder in, 210
Kitchener’s occupation of, 168
kuttab, model, established at, 222
railway from Suakin to, project of, 165, 230, 231, 244, 256, 267-269, 277
rebuilding of, 177
situation of, 191
telegraph from, to Suakin, 256, 257
Berber Province:
cotton in, 242; prospects of investment in, 244
finances of, 259
irrigation needed in, 235
sakiehs, derelict, in (1881), 148
sugar-cane cultivated in, 241
taxation in, remission of, 249; incidence of, formerly, 250
Berea, 20
Berms, nature of, 16; irrigation of, 32, 37
Bersine (Egyptian clover), 36, 39-41
Blackwater fever, 194
Blue Nile. See under Nile
Bonchamps Expedition, 170
Bongo tribe, 145, 180, 194
Bor, 119, 124, 191
Borillos, Lake, 20
Boulé, M., 73
British rule, native attitude towards, 107-109, 263
Brooke, Mr., 55
Brown, Sir Hanbury, 44, 53, 55

Cadi, office of, 203, 204

Cairo:
journey from, to Luxor, 174
Mohammedan University of, 109
Nile at—
discharges of, 16, 17
 ‘red’ water, 8
view of, 4
Caisse de la Dette, 78
Camels—breeding of, 190, 233; employment of, 232, 233
Cassel, Sir E., 79
Cattle-breeding, 190
Chak Chak, 194
Chaltin, 169
Channurmin, 194
Cholera, 144
Clover (bersine), 36, 39-41
Coal, price of, 228, 255; absence of, 245
Coast lands, sinking of, 21
Coffee, 239, 241
Commerce. See Soudan, trade
Congo Free State, 169, 187
Copper-mines, 152, 245
Corruption, 103, 197
Corvée:
abolition of, 64, 105
floods, during, 65, 66
Government right regarding, maintained, 65
hardship of, formerly, 44, 59-63
liability to serve in, 63
Mehemet Ali’s use of, 24, 27
periods of demand for, 62
remains of, 18
Cotton crop:
diseases of—‘worm’ and ‘hog’ non-existent, 244, 276
experimental farm at Shendi, 243
hardiness of, 84
irrigation of, 40-42; perennial, required, 24
seasons of, 40, 41
Soudan suitable for, 237, 241, 242;
quality produced, 243
 value of, 39
Cotton goods:
Soudanese imports of, 237, 238; demand in Kordofan, 270
Cotton, raw:
Soudanese exports of, 239, 241
Cotton, Sir Arthur, 74
Cromer, Lord (Sir Evelyn Baring): Lord Lawrence compared with, 43, 44; on the
Barrage, 58; arranges financial difficulties of Reservoir scheme, 78, 79, 82;
importance of work represented by, 100; insight of, 105; promise of,
regarding education, 225; confidence in, 274; Report of, quoted, 205, 267,
268

Dabik, 21
Dam. See Assouan Dam
Damietta Barrage:
construction of, 47, 49-53
cost of repairs to, 51
effect of, in 1884, 50
useless condition of, formerly, 30, 43
Damirah, 21
Danagla tribe, 167
Dar Nuba, 180
D’Arnaud, 127
Darfur:
Belgian advance to, 169
disturbance on borders of, 192
feathers from, 180, 239, 241
founding of sultanate of, 140
independence of, 190, 274
Ismail’s annexation of, 151, 152
Khalifa from, 165
nature of country, 188
rebellion in (1877), 155, 156; revolt against the Khalifa, 166
Sultan of, 190, 192, 193, 274
Dates, Dongola varieties of, 229
tax on, 39, 252
Dem Zubehr, 169, 194
Dembo tribe, 146
Dervishes, 165, 166, 186, 191
Dinder River, 187, 242
Dinka tribe, 145, 180, 194
Diseases:
blackwater fever, 194
cholera, 144
malaria, 189, 234
research connected with, 225
Dhurra, 236, 276
Dongola:
colony at, a failure, 227
dervish occupation of, 165
fakir charged with poisoning in, 208-210
Kitchener’s occupation of, 168
kuttab, model, established at, 222
situation of, 191
Dongola Expedition (1896), 166
Dongola Province:
climate of, 229
cotton in, 242; prospects of investment in, 244
dates in, 229
irrigation needed in, 235
Land Commission in, 202
land-tax, proportion contributed by, 259
language of, 190
Mahdi, the, a native of, 160
population of, 230
profits of, 258, 259
railway in, 229, 230
sakiehs, derelict, in (1881), 148
sugar-cane cultivated in, 241
taxation in, remission of, 249; incidence of, formerly, 250
trade of, 230
Drainage, 87, 88
Duem:
district near, 235
gum from, 240
railway from, suggested, 232
 telegraph at, 257
Duffile, 5, 119, 169

Ed Damer, 272
Edka, Lake, 20
Education. See under Soudan
Egypt:
Abyssinia, relations with. See under Abyssinia
Agricultural Bank, 105
cultivable land in, situation of, 13; amount of, 37
finances of—
Agricultural Bank, 105
Caisse de la Dette, 78
international complications of, 78
reproductive expenditure, 88, 104
government of, 261
irrigation. See Irrigation
Egypt, Lower:
crops, table of, 38
irrigation improvement in, due to Dam, 83
Egypt, Upper:
basin irrigation in, 16
characteristics of, 68, 69
crops in—
cotton, 41
rice, 42
summer, 39; increase in, due to Barrage, 50, 51, 55
table of, 38
cultivable land in, 13, 37
Egyptians:
Arab attitude towards, 223
army—
fellaheen’s dislike to service in, 33, 265
officers, grievances of, 108, 109
British rule, attitude towards, 107-109
characteristics of, 106, 109; physical, 33, 180
slave-trade encouraged by, 145, 154, 155
Soudan—
Government posts in, held by, 197, 198, 266
misrule of, 144-148