Paresthesia-Free Dorsal Root Ganglion Stimulation: An ACCURATE Study Sub-Analysis

Supraspinal Effects of Dorsal Root Ganglion Stimulation in Chronic Pain Patients

“…In contrast to the theta suppression and increase in low beta power that was observed during pain relief, DRGS produced an increase in theta activity and suppression of low beta power in the pain‐free state. While it is possible for DRGS to be programmed with subparesthetic stimulation paradigms, paraesthesias in the distribution of the targeted dermatome are still commonly observed during DRGS (40). These sensations are also likely produced independent of the neuromodulatory effect on pain relief (41).…”

Complications and Effects of Dorsal Root Ganglion Stimulation in the Treatment of Chronic Neuropathic Pain: A Nationwide Cohort Study in Denmark

“…DRG stimulation is an alternative to spinal cord stimulation (SCS) and has several proposed advantages. First, it can confine stimulation to a smaller, more specific area, thereby minimizing the risk of unwanted paresthesia outside the painful area (7). Second, it may provide stimulation in areas that can be difficult to cover with SCS such as very distal extremity areas or the torso (1,6,8).…”

“…Third, DRG stimulation is less affected by postural changes and may thereby produce a more stable stimulation (9). Fourth, DRG stimulation can often be effective even with amplitudes below the paresthesia threshold and may thus produce less paresthesia, which is preferable in some individuals (7,9).…”

Paresthesia-Free Spinal Nerve Root Stimulation for the Treatment of Chronic Neuropathic Pain

“…DRG stimulation at standard frequencies also was associated with less postural variations in intensity of paresthesias, and in some cases a lack of paresthesias altogether. In fact, a subanalysis of the ACCURATE trial demonstrated patients who were paresthesia‐free had similar or improved outcomes of pain relief, quality of life, and mood states compared to those who were not paresthesia‐free (20). This further supports the hypothesis that paresthesias are not necessary for analgesia.…”

“…Previous studies have demonstrated the efficacy of paresthesiafree stimulation in patients with dorsal column SCS (8,9,19) and DRG stimulation (20,21). To date, the efficacy of paresthesia-free stimulation in SNRS has not been evaluated in a real-world setting with long-term outcomes.…”