Spinal cord stimulation in patients with painful diabetic neuropathy: A multicentre randomized clinical trial

Vos, Cecilia Cecilia Clementine de; Meier, Kaare; Zaalberg, Paul Brocades; Nijhuis, Harold; Duyvendak, Wim; Vesper, Jan; Enggaard, Thomas P.; Lenders, Mathieu W.P.M.

doi:10.1016/j.pain.2014.08.031

Cited by 218 publications

(201 citation statements)

References 26 publications

(42 reference statements)

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“…Systematic reviews, randomized controlled trials and several case series provide evidence for the long-term efficacy of spinal cord stimulation when combined with medical treatment compared with medical management in various pain neuropathies 132–134 , and has been shown to offer sustained results at 24 months of treatment 135,136 . Two randomized trials in individuals with painful diabetic neuropathy reported greater reduction in pain and improvements in measures of quality of life compared with controls 137,138 . Current European guidelines provide a weak recommendation for spinal cord stimulation (combined with medical treatment) in, for example, diabetic neuropathic pain 118,119,139 .…”

Section: Managementmentioning

confidence: 99%

Neuropathic pain

Colloca

Ludman

Bouhassira

et al. 2017

Nat Rev Dis Primers

1,566

1,364

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Neuropathic pain is caused by a lesion or disease of the somatosensory system, including peripheral fibres (Aβ, Aδ and C fibres) and central neurons, and affects 7–10% of the general population. Multiple causes of neuropathic pain have been described and its incidence is likely to increase owing to the ageing global population, increased incidence of diabetes mellitus and improved survival from cancer after chemotherapy. Indeed, imbalances between excitatory and inhibitory somatosensory signalling, alterations in ion channels and variability in the way that pain messages are modulated in the central nervous system all have been implicated in neuropathic pain. The burden of chronic neuropathic pain seems to be related to the complexity of neuropathic symptoms, poor outcomes and difficult treatment decisions. Importantly, quality of life is impaired in patients with neuropathic pain owing to increased drug prescriptions and visits to health care providers, as well as the morbidity from the pain itself and the inciting disease. Despite challenges, progress in the understanding of the pathophysiology of neuropathic pain is spurring the development of new diagnostic procedures and personalized interventions, which emphasize the need for a multidisciplinary approach to the management of neuropathic pain.

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Section: Managementmentioning

confidence: 99%

Neuropathic pain

Colloca

Ludman

Bouhassira

et al. 2017

Nat Rev Dis Primers

1,566

1,364

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“…Spinal cord stimulation (SCS) is a therapy for chronic pain, in which epidurally implanted electrodes stimulate primary afferent (Aβ) collaterals in the dorsal columns. SCS has resulted in significant pain reduction in PDPN patients . Nevertheless, in about 40% of the patients, the treatment effect is not sufficient .…”

Section: Introductionmentioning

confidence: 99%

Dorsal Root Ganglion Stimulation in Experimental Painful Diabetic Polyneuropathy: Delayed Wash-Out of Pain Relief After Low-Frequency (1Hz) Stimulation

Koetsier

Franken

Debets

et al. 2020

Neuromodulation: Technology at the Neural Interface

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“…8,9 Thus, the legacy of the gate control theory is mostly in its application to treatment. In an early critique, Peter Nathan 26 wrote "Ideas need to be fruitful; they do not have to be right.…”

Section: Introductionmentioning

confidence: 99%

Gain control mechanisms in the nociceptive system

Treede

2016

Pain

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The "gate control theory of pain" of 1965 became famous for integrating clinical observations and the understanding of spinal dorsal horn circuitry at that time into a testable model. Although it became rapidly clear that spinal circuitry is much more complex than that proposed by Melzack and Wall, their prediction of the clinical efficacy of transcutaneous electrical nerve stimulation and spinal cord stimulation has left an important clinical legacy also 50 years later. In the meantime, it has been recognized that the sensitivity of the nociceptive system can be decreased or increased and that this "gain control" can occur at peripheral, spinal, and supraspinal levels. The resulting changes in pain sensitivity can be rapidly reversible or persistent, highly localized or widespread. Profiling of spatio-temporal characteristics of altered pain sensitivity (evoked pain to mechanical and/or heat stimuli) allows implications on the mechanisms likely active in a given patient, including peripheral or central sensitization, intraspinal or descending inhibition. This hypothesis generation in the diagnostic process is an essential step towards a mechanism-based treatment of pain. The challenge now is to generate the rational basis of multimodal pain therapy algorithms by including profile-based stratification of patients into studies on efficacy of pharmacological and nonpharmacological treatment modalities. This review outlines the current evidence base for this approach.

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Spinal cord stimulation in patients with painful diabetic neuropathy: A multicentre randomized clinical trial

Cited by 218 publications

References 26 publications

Neuropathic pain

Neuropathic pain

Dorsal Root Ganglion Stimulation in Experimental Painful Diabetic Polyneuropathy: Delayed Wash-Out of Pain Relief After Low-Frequency (1Hz) Stimulation

Gain control mechanisms in the nociceptive system

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