Columbia Neurosurgery at the 2025 North American Neuromodulation Society

Columbia Neurosurgery’s Evan Joiner, (Enfolded Neurosurgical Spine Fellowship with Dr. Dean Chou, Former Chief Resident) and medical student Andres Pascual-Leone recently traveled the North American Neuromodulation Society’s Annual Meeting in Orlando. Neuromodulation refers to the use of medical devices to provide stimulation or small doses of medication to alter the nervous system. It can be used to treat pain, movement disorders, seizures, and even mood disorders. More recently, it has been used to treat paralysis after spinal cord injury. Learn more here

Since 1994 the North American Neuromodulation Society (NANS) has maintained its vision, “to be a central resource to equip healthcare, scientific, and patient communities with advanced knowledge of neuromodulation and its promise for future treatments, as well as to expand access to neuromodulation across a broad range of disease processes.”  This year’s meeting was the largest yet, filled with groundbreaking advancements, insightful discussions, and meaningful connections across many disciplines.

Dr. Evan Joiner, who has won several awards for his innovative research on the use of neuromodulation for movement recovery after spinal cord injury, gave a talk entitled, "Comparison of epidural and transcutaneous spinal cord stimulation and their synergistic interaction with brain stimulation,” which focused on work he has done with Dr. Christopher Mandigo in the Department of Neurological Surgery and Dr. Jason Carmel in the Department of Neurology. The key takeaway from Dr. Joiner’s presentation was that epidural spinal cord stimulation has a much more robust synergistic interaction with brain stimulation than does transcutaneous spinal stimulation. When brain stimulation is combined with epidural spinal stimulation, the resultant facilitation of motor responses is 1-2 orders of magnitude greater than the facilitation observed when brain stimulation is combined with transcutaneous spinal stimulation. The synergistic effects of brain and spine stimulation matter because this form of paired stimulation is believed to hold potential to help people recover from spinal cord injury. The relative strength of this phenomenon during epidural stimulation compared to transcutaneous stimulation suggests that epidural spinal cord stimulation may provide valuable opportunities for recovery beyond what can be achieved through non-invasive techniques alone.

Says Dr. Joiner of this year’s annual meeting, “it was wonderful to connect with investigators and industry partners from around the world who are pushing the envelope on how we can use neuromodulation to recover from a variety of previously intractable conditions. Particularly within spine surgery, we have just begun to scratch the surface of what is possible, and that is tremendously exciting.”

Following medical student, Andres Pascual-Leone presented on "Optimizing Cervical Epidural Spinal Cord Stimulation Parameters for Rat Forelimb Muscles” where he shared findings illustrating the differences in muscle responses when adjusting various epidural stimulation parameters including, among others, current orientation, electrode size, and stimulation position.

Andres remarked on his experience, “This was my first time at NANS and I’m very grateful to have had the chance to attend. I listened to fascinating presentations ranging from the use of high-density cortical microarrays for recording individual neuronal firing activity to the considerations for how to best standardize brain computer interface trial outcomes across the field. I am looking forward to continuing similar neurostimulation research and I want to thank my mentor, Dr. Jason Carmel, and his lab for their support.”

The team continues its groundbreaking work in spinal cord stimulation and greatly looks forward to sharing future insights to the neuromodulation community at the upcoming 2026 Annual NANS Meeting in Las Vegas.