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DTM™ (differential target multiplexed) spinal cord stimulation (SCS) is a proprietary waveform supported by pre-clinical research and clinical research now within an RCT. DTM™ SCS is a novel spinal cord stimulation (SCS) waveform delivered via the Medtronic Intellis™ platform, to treat patients with chronic, intractable pain.
Decades of basic science research have expanded the understanding of the role of glial cells in the nervous system, which outnumber neurons 12:1 in the spinal cord.2-5
Preclinical research6-11 suggests the ability of DTM™ SCS to impact neuronal-glial cell interaction, expanding the understanding of a new SCS MoA. DTM™ waveform best modulates glial and neuronal gene expression back toward the non-pain state.
The DTM™ waveform is the first SCS therapy intentionally developed from preclinical science.7
Glia are electrically responsive cells in the spinal cord and outnumber neurons by 12:1.5 Chronic pain occurs when neuro-glial interactions get out of sync. DTM™ SCS may impact the neuronal-glial interaction.2-4
DTM™ SCS has been studied in animal models, showing statistically significant reversal of pain behaviours compared to either low frequency or high frequency alone.8 In addition, preclinical studies investigating the genome of nerve-injured animals suggests that the DTM™ waveform has a greater impact in the neural-glial interaction than other frequencies alone.8-11
The Intellis™ SCS platform combines the smallest available neurostimulator with a suite of cutting-edge technologies, outcomes, and services that redefine what clinicians and patients should expect from chronic pain management.
Study completed on the Intellis (TM) device
Under specific conditions and requires SureScan™ MRI implantable neurostimulator and leads. Refer to product labelling for full list of conditions.
See the device/therapy manual for detailed information regarding the instructions for use, the implant procedure, indications, contraindications, warnings, precautions, and potential adverse events, If using an MRI SureScanTM device, see the MRI SureScanTM technical manual before performing an MRI. For further information, contact your local Medtronic representative and/or consult the Medtronic website at medtronic.eu.
Back pain relief at 3-months compared to conventional stimulation. Fishman M, Cordner H, Justiz R, et al. Randomized Controlled Clinical Trial to Study the Effects of DTM-SCS in Treating Intractable Chronic Low Back Pain: 3 Month Results. Presentation at NANS 2020, Las Vegas, Nevada. Study done with the Intellis™ device.
Milligan ED, Watkins LR. Pathological and protective roles of glia in chronic pain. Nat Rev Neurosci. 2009 Jan;10(1):23-36.
Vallejo R, Tilley DM, Vogel L, Benyamin R. The role of glia and the immune system in the development and maintenance of neuropathic pain. Pain Pract. 2010 May-Jun;10(3):167-84.
De Leo JA, Tawfik VL, LaCroix-Fralish ML. The tetrapartite synapse: Path to CNS centralization and chronic pain. Pain. 2006; 122:17-21.
Ruiz-Sauri A., Orduña-Valls J.M., Blasco-Serra A. et al. Glia to neuron ratio in the posterior aspect of the human spinal cord at thoracic segments relevant to spinal cord stimulation. Journal of Anatomy, vol. 235, no. 5, 2019, pp. 997-1006.
Cedeno D.L., Cass C.L., Kelley C.A., et al. Pre-clinical Comparison of Differential-Target Multiplexed SCS with Low and High Rate SCS. Neuromodulation 2019 22:3 (E185-)
Cedeno D.L., Kelley C.A., Cass C.L., et al. Pre-clinical Comparison of Differential-Target Multiplexed SCS with Low and High Rate SCS. Presentation at ASRA 2018. San Antonio, Texas.
Vallejo R, Kelley CA, Gupta A, Smith WJ, Vallejo A, Cedeño DL. Modulation of neuroglial interactions using differential target multiplexed spinal cord stimulation in an animal model of neuropathic pain. Mol Pain. 2020 Jan-Dec;16:1744806920918057.
Vallejo R, Smith W, Kelley C, et al. Neuron-glial inflammasome enhanced reversal by DTM-SCS relative to high rate and low rate SCS in a neuropathic pain model. American Society for Regional Anesthesiology and Pain Medicine (ASRA); November 14-17, 2019; New Orleans, LA. Abstract #480
Vallejo R, Kelley C, Smith W, et al. Cell-specific targeting in neural tissue using Differential Target Multiplexed (DTM) SCS. American Society for Regional Anesthesiology and Pain Medicine (ASRA); November 14-17, 2019; New Orleans, LA. Abstract #513
Vallejo R, Tilley D, Kelley C, et al. Proteomics of Differential Target Multiplexed-SCS applied to an animal model of neuropathic pain. American Society for Regional Anesthesiology and Pain Medicine (ASRA); November 14-17, 2019; New Orleans, LA. Abstract #509
Fishman M, Cordner H, et al. DTM™ SCS RCT 12-month data results. Presented at a Medtronic webinar, jointly supported by the North American Neuromodulation Society (NANS), World Institute of Pain (WIP), and the American Society for Pain and Neuroscience (ASPN). October 19, 2020. Webinar available on society websites.