TY - JOUR
T1 - Observing Altered Nociceptive Detection Thresholds in Patients With Persistent Spinal Pain Syndrome Type 2 With a Dorsal Root Ganglion Stimulator
AU - Berfelo, Tom
AU - Doll, Robert-Jan
AU - Krabbenbos, Imre Poldino
AU - Buitenweg, Jan Reinoud
N1 - Funding Information:
This work is part of the research program PAINSIGHT with project number 10740, which is financed by the Dutch Research Council (NWO). The study was conducted at St. Antonius Hospital, Nieuwegein, The Netherlands. Imre Poldino Krabbenbos and Robert-Jan Doll designed the study. Imre Poldino Krabbenbos and Tom Berfelo performed patient recruitment and data collection. Robert-Jan Doll performed data analysis with intellectual input from Tom Berfelo and Jan Reinoud Buitenweg. Tom Berfelo prepared the manuscript draft with intellectual input from Robert-Jan Doll, Imre Poldino Krabbenbos, and Jan Reinoud Buitenweg. The Dutch Research Council (NWO) provided funding for the study, which was requested by Jan Reinoud Buitenweg. All authors approved the final manuscript. Source(s) of financial support: This work is part of the research program PAINSIGHT with project number 10740, which is financed by the Dutch Research Council (NWO).
Funding Information:
Source(s) of financial support: This work is part of the research program PAINSIGHT with project number 10740, which is financed by the Dutch Research Council (NWO).
Publisher Copyright:
© 2021 International Neuromodulation Society
Financial transaction number:
342164192
PY - 2022/10
Y1 - 2022/10
N2 - Objectives: There is a lack of clinically relevant measures for quantification of maladaptive mechanisms of the nociceptive system leading to chronic pain. Recently, we developed a method that tracks nociceptive detection thresholds (NDTs) using intraepidermal electrical stimulation. In this study, we explored the feasibility of using this NDT method in patients with persistent spinal pain syndrome type 2 (PSPS-T2) and its potential to enable observation of altered nociceptive processing induced by dorsal root ganglion (DRG) stimulation. In addition, we compared NDTs with quantitative sensory testing (QST) measurements and numeric rating scale (NRS). Materials and Methods: A total of 12 patients with PSPS-T2 (seven men; 60.4 ± 12.3 years) experiencing chronic unilateral lower limb pain treated with DRG stimulation were included in the study. Both the NDT method and electrical and pressure QST methods were performed twice in the L5 dermatome on both the affected and the unaffected foot, once with the DRG stimulator turned off and, subsequently, once with the DRG stimulator turned on. Results: The NDT method can be applied to patients with PSPS-T2. With the DRG stimulator turned off, NDTs on the affected side were significantly higher than on the unaffected side. This difference was no longer present once the DRG stimulator was turned on. Furthermore, DRG stimulation affected QST (electrical and pressure) values and NRS scores. Finally, NDTs showed larger contrasts between the sides than QST measures. Conclusions: The NDT method permitted observation of altered nociceptive function. The effect of DRG stimulation also was reflected in QST outcomes and NRS scores. The larger contrast between the sides for NDTs suggests that the NDT method might be valuable for future quantification of nociceptive dysfunction in chronic pain.
AB - Objectives: There is a lack of clinically relevant measures for quantification of maladaptive mechanisms of the nociceptive system leading to chronic pain. Recently, we developed a method that tracks nociceptive detection thresholds (NDTs) using intraepidermal electrical stimulation. In this study, we explored the feasibility of using this NDT method in patients with persistent spinal pain syndrome type 2 (PSPS-T2) and its potential to enable observation of altered nociceptive processing induced by dorsal root ganglion (DRG) stimulation. In addition, we compared NDTs with quantitative sensory testing (QST) measurements and numeric rating scale (NRS). Materials and Methods: A total of 12 patients with PSPS-T2 (seven men; 60.4 ± 12.3 years) experiencing chronic unilateral lower limb pain treated with DRG stimulation were included in the study. Both the NDT method and electrical and pressure QST methods were performed twice in the L5 dermatome on both the affected and the unaffected foot, once with the DRG stimulator turned off and, subsequently, once with the DRG stimulator turned on. Results: The NDT method can be applied to patients with PSPS-T2. With the DRG stimulator turned off, NDTs on the affected side were significantly higher than on the unaffected side. This difference was no longer present once the DRG stimulator was turned on. Furthermore, DRG stimulation affected QST (electrical and pressure) values and NRS scores. Finally, NDTs showed larger contrasts between the sides than QST measures. Conclusions: The NDT method permitted observation of altered nociceptive function. The effect of DRG stimulation also was reflected in QST outcomes and NRS scores. The larger contrast between the sides for NDTs suggests that the NDT method might be valuable for future quantification of nociceptive dysfunction in chronic pain.
KW - Dorsal root ganglion stimulation
KW - generalized linear mixed model
KW - nociceptive detection threshold
KW - nociceptive processing
KW - PSPS-T2 patients
KW - 22/1 OA procedure
UR - http://www.scopus.com/inward/record.url?scp=85124842913&partnerID=8YFLogxK
U2 - 10.1016/j.neurom.2021.10.023
DO - 10.1016/j.neurom.2021.10.023
M3 - Article
C2 - 35088721
AN - SCOPUS:85124842913
VL - 25
SP - 1006
EP - 1014
JO - Neuromodulation
JF - Neuromodulation
SN - 1094-7159
IS - 7
ER -