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Study design: Case series. Objectives: To evaluate relationships between spinal cord stimulation (SCS) parameters and levels of glial cell-derived neurotrophic factor (GDNF). Setting: Ambulatory pain clinic of St James's Hospital, Dublin, Ireland. Methods: Nine patients with an implanted SCS and Failed Back Surgery Syndrome (FBSS) were administered the Brief Pain Inventory and Short Form (36) Health Survey. Following a lumbar puncture, levels of GDNF in cerebrospinal fluid (CSF) were assayed and correlated with stimulation parameters. Controls were patients with arthritic back pain who were matched for age, gender and SF-36 score. Results: Concentrations of GDNF in CSF are higher in patients with FBSS than controls (P ¼ 0.002) and correlate with SCS frequency (P ¼ 0.029). Conclusion: Concentrations of GDNF in CSF are higher in neuropathic pain and appear to be related to stimulation frequency. Further work is needed to evaluate this potential relationship, both in neuropathic pain and in other contexts such as locomotor dysfunction.

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