DTM™ SCS WAVEFORM SPINAL CORD STIMULATION

DTM™ SCS is a novel spinal cord stimulation (SCS) waveform delivered via the Medtronic Intellis™ platform, to treat patients with chronic, intractable pain.

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DTM™ SCS OVERVIEW

DTM™ (differential target multiplexed) spinal cord stimulation (SCS) is a proprietary waveform supported by preclinical research and clinical research now within an RCT.

SCIENCE THAT

MATTERS

BEYOND THE NEURON

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.1-4

INSPIRED BY SCIENCE

The DTM™ waveform is the first SCS therapy intentionally developed from preclinical science.

TOWARD A NEW THEORY

Preclinical research5-9 suggests the ability of DTM™ SCS to impact neuronal-glial cell interaction, expanding the understanding of a new SCS MoA. 

PROVEN ONLY

ON THE INTELLIS PLATFORM

In an RCT (n=94), DTM™ SCS delivered superior back pain relief (p = 0.0009) at three months for people living with chronic back and leg pain, compared to conventional stimulation.10

evolution of dtm™ scs

hypothesized NOVEL MECHANISM

Glia are electrically responsive cells in the spinal cord and outnumber neurons by 12:1.4 Chronic pain occurs when neuro-glial interactions get out of sync. DTM™ SCS may impact the neuronal-glial interaction.1-3

PRE-CLINICAL WORK

The  DTM™ waveform has been studied in animal models, showing statistically significant reversal of pain behaviors compared to either low frequency or high frequency alone.5,6 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.5-9

ADAPTING THE SCIENCE INTO HUMANS

DTM™ SCS therapy is a unique programming option available to treat patients with chronic pain. A randomized control trial has shown DTM™ SCS results in superior back pain relief compared to conventional SCS in patients with chronic pain.10



THE INTELLIS™ PLATFORM

The Intellis™ SCS platform combines the smallest neurostimulator with a suite of cutting-edge technologies, outcomes, and services that redefine what clinicians and patients should expect from chronic pain management.

INTELLIS

SCS

Designed to overcome limitations of other SCS systems

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The Intellis product family for spinal cord stimulation

SURESCAN

MRI

Ensures the broadest access to full-body MRI*

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OVERDRIVE

BATTERY

Minimizes fade and ensures fast, easy recharging

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ADAPTIVESTIM

TECHNOLOGY

Adjusts automatically as patients change position

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EVOLVE<sup>SM</sup>

WORKFLOW

Balances simplicity and versatility to optimize the patient experience

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*

MR Safety Triangle Under specific conditions and requires SureScan™ MRI implantable neurostimulator and leads. Refer to product labeling for full list of conditions.

1

Milligan ED, Watkins LR. Pathological and protective roles of glia in chronic pain. Nat Rev Neurosci. 2009 Jan;10(1):23-36.

2

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.

3

De Leo JA, Tawfik VL, LaCroix-Fralish ML. The tetrapartite synapse: Path to CNS centralization and chronic pain. Pain. 2006; 122:17-21.

4

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.

5

Cedeno D.L., Cass C.L., Kelley C.A., et al. Pre-clinical comparison of differential-target multiplexed scstm with low and high rate SCS. Neuromodulation 2019 22:3 (E185-)

6

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.

7

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 

8

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

9

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

10

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.