Effect and safety of spinal cord stimulation for treatment of chronic pain caused by diabetic neuropathy

Vos, Cecile C de; Rajan, Vinayakrishnan; Steenbergen, Wiendelt; Aa, H.E. van der; Buschman, H.P.J.

doi:10.1016/j.jdiacomp.2007.08.002

Cited by 95 publications

(61 citation statements)

References 18 publications

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“…A 2-week trial stimulation with predefined criteria was used to evaluate the efficacy of SCS. A negative trial stimulation was noted in 23% of the SCS patients, which is in line with previously published studies (10)(11)(12). These patients reported ,10% pain relief during daytime and nighttime, as well as no change on the PGIC scale.…”

Section: Discussionsupporting

confidence: 90%

“…Data from prospective pilot studies were used to estimate the required sample size (10)(11)(12)28). The prespecified definition of clinically relevant pain relief was a reduction of 50% on the NRS and/or improvement on the PGIC for pain and sleep.…”

Section: Discussionmentioning

confidence: 99%

“…Several observational studies suggested that SCS may have a positive effect on pain in PDPN patients, with 23 out of 31 patients (74%) reporting a pain relieving effect of $50% after 1 year of treatment (9)(10)(11)(12)(13). Three studies reported a sustained treatment effect (2-7 years) of SCS in PDPN patients (9,10,14).…”

mentioning

confidence: 99%

“…Three studies reported a sustained treatment effect (2-7 years) of SCS in PDPN patients (9,10,14). As SCS is a relatively expensive therapy (;12,000 Euros per patient) and not without risks, such as technical complications, there is a need for randomized controlled trials (RCTs) confirming its effectiveness in PDPN.…”

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confidence: 99%

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Spinal Cord Stimulation and Pain Relief in Painful Diabetic Peripheral Neuropathy: A Prospective Two-Center Randomized Controlled Trial

et al. 2014

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OBJECTIVEPainful diabetic peripheral neuropathy (PDPN) is a common complication of diabetes mellitus. Unfortunately, pharmacological treatment is often partially effective or accompanied by unacceptable side effects, and new treatments are urgently needed. Small observational studies suggested that spinal cord stimulation (SCS) may have positive effects. RESEARCH DESIGN AND METHODSWe performed a multicenter randomized clinical trial in 36 PDPN patients with severe lower limb pain not responding to conventional therapy. Twenty-two patients were randomly assigned to SCS in combination with the best medical treatment (BMT) (SCS group) and 14 to BMT only (BMT group). The SCS system was implanted only if trial stimulation was successful. Treatment success was defined as ‡50% pain relief during daytime or nighttime or "(very) much improved" for pain and sleep on the patient global impression of change (PGIC) scale at 6 months. RESULTSTrial stimulation was successful in 77% of the SCS patients. Treatment success was observed in 59% of the SCS and in 7% of the BMT patients (P < 0.01). Pain relief during daytime and during nighttime was reported by 41 and 36% in the SCS group and 0 and 7% in the BMT group, respectively (P < 0.05). Pain and sleep were "(very) much improved" in 55 and 36% in the SCS group, whereas no changes were seen in the BMT group, respectively (P < 0.001 and P < 0.05). One SCS patient died because of a subdural hematoma. CONCLUSIONSTreatment success was shown in 59% of patients with PDPN who were treated with SCS over a 6-month period, although this treatment is not without risks.Painful diabetic peripheral neuropathy (PDPN) is a common complication of diabetes mellitus (DM), and prevalence of PDPN ranges from 10 to 26% (1-3). In many patients, the pain is of such intensity that it has a major impact on patients' health-related quality of life (HRQoL) and functional ability, including interference with general activity, mood, mobility, work, social relations, sleep, and enjoyment of life (4).

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Spinal Cord Stimulation and Pain Relief in Painful Diabetic Peripheral Neuropathy: A Prospective Two-Center Randomized Controlled Trial

et al. 2014

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“…In addition, there will be DPN in 30-50% diabetic patients by 2025 according to the prediction from WHO 4 . Therefore, in order to ameliorate the patient's clinical symptoms and control the development of DPN, the comprehensive treatments are used, such as control of blood glucose, oral Duloxetine and Pregabalin, interventional therapy and surgical treatment [5][6][7][8] . Regardless, the exact pathogenesis of DPN is not fully understood until now.…”

Section: ■ Introductionmentioning

confidence: 99%

A curcumin derivative J147 ameliorates diabetic peripheral neuropathy in streptozotocin (STZ)-induced DPN rat models through negative regulation AMPK on TRPA1

Cao

Zhang

et al. 2018

Acta Cir. Bras.

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A curcumin derivative J147 ameliorates diabetic peripheral neuropathy in streptozotocin (STZ)-induced DPN rat models through negative regulation AMPK on TRPA1 1 8-Experimental SurgeryActa Cir Bras. 2018;33(6):533-541 AbstractPurpose: To investigate the specific molecular mechanisms and effects of curcumin derivative J147 on diabetic peripheral neuropathy (DPN). Methods: We constructed streptozotocin (STZ)-induced DPN rat models to detected mechanical withdrawal threshold (MWT) in vivo using Von Frey filaments. In vitro, we measured cell viability and apoptosis, adenosine 5'-monophosphate-activated protein kinase (AMPK) and transient receptor potential A1 (TRPA1) expression using MTT, flow cytometry, qRT-PCR and western blot. Then, TRPA1 expression level and calcium reaction level were assessed in agonist AICAR treated RSC96cells. Results:The results showed that J147reduced MWT in vivo, increased the mRNA and protein level of AMPK, reduced TRPA1 expression and calcium reaction level in AITCR treated RSC96 cells, and had no obvious effect on cell viability and apoptosis. 18 reports that J147 improves the depression-like behavior in mouse models caused by chronic stress, and its mechanism may involve the regulation of cAMP/pCREB/ BDNF pathway.Due to curcumin can relieve diabetic peripheral neuropathic pain 14 , we aimed to investigate the specific molecular mechanisms and effects of J147 on DPN through the establishment of DPN rat models, cell viability and apoptosis assay in this study. ■ Methods DPN rat modelsEthical Guidelines were approved by the Ethical Committee of Shanxi University of Traditional Chinese Medicine.The 30 adult male SPF rats (weighing 200 ± 20g) were obtained from Institute of Laboratory Animal Science, Chinese Academy of Medical Science (Beijing, China). They were housed in stainless steel squirrel cages with food and water available ad libitum. The breeding room was kept at 20°C, 70% humidity and 12 h of light.SPF rats were weighed after fasting for 12 h, and streptozotocin(STZ) solution (Solarbio, Beijing, China) was injected intraperitoneally at 50 mg/kg weight. After 4 h of injection, the rats resumed their diet ■ IntroductionDiabetic peripheral neuropathy (DPN) is one of the major disability factors and the most common chronic neurological complications in diabetes 1 . The clinical manifestations of this disease are distal symmetric pain with paresthesia, like numbness, ant walking, insect crawling, fever, electric shock, and motor neurological disorders 2,3 .Further, severe DPN patients may develop lower extremity arthropathy and ulcers 2 . In addition, there will be DPN in 30-50% diabetic patients by 2025 according to the prediction from WHO 4 . Therefore, in order to ameliorate the patient's clinical symptoms and control the development of DPN, the comprehensive treatments are used, such as control of blood glucose, oral Duloxetine and Pregabalin, interventional therapy and surgical treatment [5][6][7][8] . Regardless, the exact pathogenesis of DPN is not fully understood until now. ...

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Painful Diabetic Polyneuropathy

Pluijms¹,

Huygen²,

Cheng³

et al. 2011

Evidence‐Based Interventional Pain Medicine

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Effect and safety of spinal cord stimulation for treatment of chronic pain caused by diabetic neuropathy

Cited by 95 publications

References 18 publications

Spinal Cord Stimulation and Pain Relief in Painful Diabetic Peripheral Neuropathy: A Prospective Two-Center Randomized Controlled Trial

Spinal Cord Stimulation and Pain Relief in Painful Diabetic Peripheral Neuropathy: A Prospective Two-Center Randomized Controlled Trial

A curcumin derivative J147 ameliorates diabetic peripheral neuropathy in streptozotocin (STZ)-induced DPN rat models through negative regulation AMPK on TRPA1

Painful Diabetic Polyneuropathy

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