Image: The novel stimulation device is designed to aid neuropathic nerve recovery (Photo courtesy of Xavant Technology).
A novel device treats peripheral diabetic neuropathy (PDN) by subjecting damaged nerves to pulsed radiofrequency (PRF) electromagnetic waves.
The therapeutic effect of the Xavant Technology (Pretoria, South Africa) Stimpod NMS460 is based on cellular metabolic activity induced by the electromagnetic energy beamed to a neuropathic nerve, which seems to change its characteristics, and in many cases causing the nerve to recover its normal function. There are typically four phases associated with such a PRF procedure: a stunning phase that provides immediate relief; a phase of post-procedural discomfort; a phase of beneficial clinical effect; and lastly, a possible phase that involves pain recurrence or paralysis.
To locate the affected sensory nerve, a monophasic square wave is delivered transcutaneously by a pen-shaped mapping probe. Once near the adjacent motor nerve, the stimulation causes fasciculation of the relevant muscle; the closer the probe, the stronger the fasciculation. When pure sensory nerves need to be located, patient feedback is used. The closer the mapping pen gets to the sensory nerve, the stronger the sensation will be. The Stimpod NMS460 then delivers the PRF waveform, which creates discomfort in a healthy sensory nerve; however, the sensation to a neuropathic nerve is usually very comfortable.
Recovery of sensory nerves can be measured by the comfort experienced at different levels of stimulus intensity. For example, treating a neuropathic nerve at 30 mA at the first treatment may be comforting. But as the nerve recovers, current intensity would need to be reduced in order to maintain a comfort level for the patient in subsequent treatments; this provides a quantifiable measure of progress. The same goes for motor nerves, but rather than the sensation, a progress judgment can be made on the intensity level of the fasciculation.
“We are thrilled to see that our technology continues to prove that it can impact positively on the population of diabetic patients to whom there are otherwise limited options of treatment, often plagued with exorbitant cost and severe side effects,” said Corlius Birkill, CEO of Xavant Technology, speaking at the 11th Diabetologists Conference, held during May 2018 in New York (NY, USA). “We attend conferences like these to spread awareness of a disruptive treatment option that truly embodies the vision of Xavant Technology, which is, to contribute to a healthy, vibrant and compassionate world.”
Diabetic neuropathies are thought to result from a diabetic microvascular injury involving small blood vessels that supply the nerves, in addition to macrovascular conditions that can accumulate in diabetic neuropathy. Conditions associated with diabetic neuropathy include third, fourth, or sixth cranial nerve palsy; mononeuropathy; mononeuropathy multiplex; diabetic amyotrophy; a painful polyneuropathy; autonomic neuropathy; and thoracoabdominal neuropathy.