Quantitative sensory phenotyping in chronic neuropathic pain patients treated with unilateral L4-dorsal root ganglion st
- PDF / 1,455,621 Bytes
- 14 Pages / 595.276 x 790.866 pts Page_size
- 111 Downloads / 180 Views
Journal of Translational Medicine Open Access
RESEARCH
Quantitative sensory phenotyping in chronic neuropathic pain patients treated with unilateral L4‑dorsal root ganglion stimulation Thomas Kinfe1*†, Nico von Willebrand2†, Andreas Stadlbauer3, Michael Buchfelder3, Thomas L. Yearwood4, Sajjad Muhammad5, Shafqat R. Chaudhry6, Sascha Gravius7, Thomas Randau8, Klemens Winder9, Christian Maihöfner10, Nadine Gravius7† and Walter Magerl11†
Abstract Background: In a previous study, we reported that selective dorsal root ganglion stimulation ( DRGSTIM) at DRG level L4 promoted a favorable outcome for complex regional pain syndrome (CRPS) patients along with D RGSTIM-related changes of inflammatory biomarkers in blood and saliva. The impact on somatosensation is largely unknown. Herein, we assessed the quantitative sensory profile to quantify L4-DRGSTIM effects in CRPS patients. Methods: Twelve refractory CRPS patients (4 female; 8 male; mean age 69 ± 9 years) received standardized quantitative sensory testing (QST) protocol at baseline and after 3 months of unilateral L4-DRGSTIM assessing nociceptive and non-nociceptive thermal and mechanical sensitivity of the knee affected by CRPS and the contralateral non-painful knee area. Results: At baseline, CRPS subjects showed significantly increased thresholds for warmth, tactile and vibration detection (WDT, MDT and VDT) and exaggerated pain summation (WUR). After 3 months of unilateral L4-DRGSTIM all pain parameters exhibited trends towards normalization of sensitivity accumulating to a significant overall normalization for pain sensitivity (effect size: 0.91, p 0.40). Notably, reduction of pain summation (WUR) correlated significantly with pain reduction after 3 months of L4-DRGSTIM. Conclusions: Selective L4-DRGSTIM lowered ongoing pain in CRPS patients and evoked significant normalization in the pain domain of the somatosensory profile. Thermoreception and mechanoreception remained unchanged. However, larger randomized, sham-controlled trials are highly warranted to shed more light on effects and mechanisms of dorsal root ganglion stimulation on quantitative sensory characteristics. The study protocol was registered at the 15.11.2016 on German Register for Clinical Trials (DRKS ID 00011267).
*Correspondence: thomas.kinfe@uk‑erlangen.de † Thomas M. Kinfe and Nico von Willebrand contributed equally † Walter Magerl and Nadine Gravius contributed equally 1 Division of Functional Neurosurgery and Stereotaxy, Department of Neurosurgery, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen, Germany Full list of author information is available at the end of the article © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Th
Data Loading...
