Correlation between spinal cord stimulation analgesia and cortical dynamics in pain management

Abstract

AimSpinal cord stimulation (SCS) is an effective method to treat neuropathic pain. It is necessary to identify the responders of SCS analgesia before implantation. The aim of this study is to investigate the relationship between the cortical dynamics and SCS analgesia responders in pain management.MethodsResting‐state EEG recording was performed in patients who underwent short‐term implantation of spinal cord stimulation for pain therapy. We then did spectral analysis to capture the pattern of cortical oscillation between neuromodulation therapy analgesia responders and nonresponders.ResultsAbout 58.3% (14 out of 24) of participants were considered as analgesia responders, with average visual analogue scores reduction of 4.8 ± 1.0 after surgery, and 2.1 ± 0.7 for the nonresponder subgroup, respectively. The alpha oscillation was significantly enhanced in responder cohort compared with nonresponders. We also observed an increasing spectral power of gamma band in responders. Furthermore, the attenuation of pain severity was significantly correlated with the global alpha oscillation activity (r = 0.60, P = 0.002). Likely, positive and significant correlation was found between the pain relief and gamma activity (r = 0.58, P = 0.003).ConclusionsDistinct pattern of neural oscillation is associated with the analgesic effect of spinal cord stimulation in pain management, enhancement of cortical alpha and gamma oscillation may be a predictor of analgesia responders.

Central and peripheral dual neuromodulation strategy in pain management of zoster-associated pain：a retrospective cohort study

“…During postoperative follow-up, a reduction in VAS score of 50% or more compared to the baseline score upon admission was de ned as a responder [13] .…”

“…However, for patients with severe pain, SCS may not be fully effective, and some patients continue to experience moderate or severe pain after discharge. A recent study showed that 41.7% of ZAP patients treated with SCS had less than 50% pain reduction at discharge [13] . Another review summarized the long-term follow-up of various types of SCS in the treatment of PHN, noting that 32.1% of patients still had unsatisfactory pain relief [14] .…”