Meet a Pioneer of Modern Neurostimulation for Pain Relief

Abbott Labs’ BurstDR stimulation is an advanced neurostimulation therapy that was engineered to manage chronic pain by mimicking natural brain signaling. It employs mild electrical pulses to interrupt pain signals and reduce the suffering and emotional stress caused by chronic pain.

The U.S. Food and Drug Administration (FDA) first cleared BurstDR stimulation for patients with St. Jude Medical (now Abbott) Proclaim and Prodigy MRI spinal cord stimulation systems in 2016. Approval for low-dose, recharge-free neurostimulation with BurstDR followed in 2019. The Proclaim Plus system with FlexBurst360 therapy then arrived in 2022, letting doctors tailor stimulation across up to six different areas of the trunk and limbs.

Proclaim XR with BurstDR was approved to treat chronic, intractable pain caused by diabetic peripheral neuropathy in 2023. That year also saw FDA approval of the Proclaim and Eterna families for patients with chronic back pain who aren’t eligible for surgery.

To gain more insights about Abbott’s BurstDR stimulation technology, ODT spoke to Dirk De Ridder, MD, Ph.D. Professor De Ridder is a distinguished Belgian neurosurgeon and neuroscientist, globally acclaimed for his contributions to neuromodulation and the treatment of phantom perceptions like tinnitus and chronic pain.

Professor De Ridder earned his medical degree from Ghent University in 1992 and later obtained a Ph.D. from the University of Antwerp, where his research focused on a Darwinian neurosurgical approach to tinnitus. He currently works as a professor of neurosurgery at the University of Otago in Dunedin, New Zealand. He splits his time between New Zealand and Belgium, where he co-directs a private neuromodulation clinic, and maintains academic affiliations with Manipal University (India), Trinity College Dublin (Ireland), and the University of Bonn (Germany).

He’s co-edited four books, authored 56 book chapters, and published more than 340 peer-reviewed articles indexed on PubMed. Professor De Ridder’s research integrates basic neuroscience with clinical neurosurgery, using non-invasive (TMS, tDCS) and invasive (brain implants) neuromodulation techniques. He’s a strong proponent of translational neuroscience and committed to transforming scientific insights into effective clinical therapies.

Furthermore, the “DR” in BurstDR stands for De Ridder. Here’s what he had to say:

Sam Brusco: How did the idea for BurstDR stimulation come about?

Professor Dirk De Ridder: The idea of BurstDR was inspired by the famous Catalan architect Antoni Gaudi, who stated that the architect of the future should be built by mimicking nature. Spinal cord stimulation had already existed for more than 50 years, mimicking tonic firing in the nervous system. Unlike traditional tonic stimulation, BurstDR stimulation mimics the second language of the brain—burst firing, which overrides tonic activity when something salient occurs. BurstDR is a more powerful signal that not only addresses the lateral “painfulness” pathway provoked by chronic pain, but also the medial “suffering” pathway.

Brusco: How does BurstDR stimulation improve upon other SCS waveforms on the market?

Prof. De Ridder: Abbott’s BurstDR SCS therapy uses low-energy, electrical bursts to change pain signals as they travel from the spinal cord to the brain. It is designed to influence neural pathways more effectively and efficiently, inducing stronger and longer-lasting changes than traditional, less patterned stimulation. Studies have shown that patients report BurstDR is more comfortable and preferred to traditional tonic stimulation.^2,3 In addition, patients utilizing BurstDR have experienced superior pain relief^4,5, and shown significant reduction in the impact chronic pain has on their emotional and mental states, particularly as it relates to “pain catastrophizing,” worrying about future pain that may magnify pain sensations.⁶

Brusco: What potential does BurstDR stimulation provide for global pain treatment?

Prof. De Ridder: Unlike traditional stimulation, BurstDR has shown consistent effectiveness across a range of patient-reported outcomes with little or no decline in therapeutic effect over time, showcasing BurstDR’s ability to deliver sustained, long-term relief for patients. BurstDR is currently only approved in the U.S. for Abbott’s spinal cord stimulation devices, but innovations like these are key to addressing the global burden of chronic pain and can hopefully pave the way for new methods of addressing chronic pain.

Brusco: Anything else you’d like to say about BurstDR technology and chronic pain treatment?

Prof. De Ridder: BurstDR has was initially delivered at high amplitudes continuously. Science has taught us that in contrast to tonic stimulation for BurstDR “less is more” is the guiding principle.

This has been implemented by:

1. Reducing the amplitude
2. Stimulating only intermittently
3. Delivering the lowest dose at the right place with Flexburst360

Future endeavors may further optimize BurstDR by potentially adjusting other stimulation parameters or combining it with novel stimulation designs, but BurstDR is here to stay.

References
¹ Vanneste S, De Ridder D. BurstDR spinal cord stimulation rebalances pain input and pain suppression in the brain in chronic neuropathic pain. Brain Stimul. 2023 Jul-Aug;16(4):1186-1195. doi: 10.1016/j.brs.2023.07.058. Epub 2023 Aug 2. PMID: 37541579.
² Deer, T. Randomized, Controlled Trial Assessing Burst Stimulation for Chronic Pain: 2-Year Outcomes from the SUNBURST Study. Presented at NANS 2018.
³ Deer T, Slavin KV, Amirdelfan K, et al. Success Using Neuromodulation With BURST (SUNBURST) Study: Results From a Prospective, Randomized Controlled Trial Using a Novel Burst Waveform. Neuromodulation. 2017;20(6):543-552.
⁴ Abbott Medical Devices. Spinal cord stimulation vs. medical management for low back pain (DISTINCT). US National Library of Medicine. 2023; NCT04479787. Accessed May 8, 2023. http://clinicaltrials.gov/ct2/show/NCT04479787.
⁵ Yue JJ, Gilligan CJ, Falowski S, et al. Surgical treatment of refractory low back pain using implanted BurstDR spinal cord stimulation (SCS) in a cohort of patients without options for corrective surgery: findings and results from the DISTINCT study, a prospective randomized multi-center controlled trial. Spine J. 2022;22(9):S120-S121. https://doi.org/10.1016/j.spinee.2022.06.246 Abbott. Clinical Summaries for Spinal Cord Stimulation Systems Clinician’s Manual. 2023.
⁶ Science Direct. Pain Catastrophizing. Accessed January 15, 2025. https://www.sciencedirect.com/topics/medicine-and-dentistry/pain-catastrophizing#definition