Cerebral current-source distribution associated with pain improvement by non-invasive painless signaling therapy in patients with failed back surgery syndrome

Abstract

Background Non-invasive painless signaling therapy (NPST) is an electro-cutaneous treatment that converts endogenous pain information into synthetic non-pain information. This study explored whether pain improvement by NPST in failed back surgery syndrome (FBSS) patients is related to cerebral modulation. Methods Electroencephalography (EEG) analysis was performed in 11 patients with FBSS. Subjects received daily NPST for 5 days. Before the first treatment, patients completed the Brief Pain Inventory (BPI) and Beck Depression Inventory and underwent baseline EEG. After the final treatment, they responded again to the BPI, reported the percent pain improvement (PPI), and then underwent post-treatment EEG. If the PPI grade was zero, they were assigned to the ineffective group, while all others were assigned to the effective group. We used standardized low-resolution brain electromagnetic tomography (sLORETA) to explore the EEG current-source distribution (CSD) associated with pain improvement by NPST. Results The 11 participants had a median age of 67.0 years, and 63.6% were female. The sLORETA images revealed a beta-2 CSD increment in 12 voxels of the right anterior cingulate gyrus (ACG) and the right medial frontal area. The point of maximal CSD changes was in the right ACG. The alpha band CSD increased in 2 voxels of the left transverse gyrus. Conclusions Pain improvement by NPST in FBSS patients was associated with increased cerebral activity, mainly in the right ACG. The change in afferent information induced by NPST seems to be associated with cerebral pain perception.

Graded exercise with motion style acupuncture therapy for a patient with failed back surgery syndrome and major depressive disorder: a case report and literature review

“…The peripheral stimulus-derived opioids 5-hydroxytryptamine (5-HT) and norepinephrine in the CNS are believed to regulate inflammatory and neuropathic pain ( 30 , 31 ). A study using electroencephalography suggested that pain improvement following electrocutaneous treatment in patients with FBSS was associated with increased cerebral activity, primarily in the anterior cingulate gyrus, which participates in pain and emotion processing ( 32 , 33 ). Likewise, the acupoint LR3 employed in this case is recognized for its modulatory effects on pain perception and emotional functions ( 20 ).…”

The analgesic effect of lumbar sympathetic ganglion block in patients with failed back surgery syndrome

“…FBSS remains difficult to manage due to its lack of precise pathophysiology and complexity of causes, and various clinical symptoms ( 18 ). In FBSS management, level one treatment includes pharmacological and non-pharmacological therapy, such as acupuncture and physiotherapy ( 18 , 19 ). Level two treatment is recommended when level one treatment is unsuccessful; it includes selective root block, other spinal injections, and epidural adhesiolysis ( 18 , 20 ).…”

Chronic pain after spine surgery: Insights into pathogenesis, new treatment, and preventive therapy

“…Some authors recommended the application of IDD for CPSS when SCS and DRG stimulation treatment cannot provide satisfying pain relief (Level Ⅱ) [ 121 ]. In addition, a recent study showed that non-invasive painless signaling therapy (NPST) relieved the pain of CPSS patients [ 122 ]. NPST is an electrodermal therapy that converts pain information into synthetic non-pain information [ 122 ].…”

“…In addition, a recent study showed that non-invasive painless signaling therapy (NPST) relieved the pain of CPSS patients [ 122 ]. NPST is an electrodermal therapy that converts pain information into synthetic non-pain information [ 122 ]. Electroencephalography data suggest that pain reduction by NPST in CPSS patients was associated with increased activity in the right anterior cingulate gyrus.…”