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Acta Neurochirurgica

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Open Access 01-04-2022 | Neuropathic Pain | Original Article - Functional Neurosurgery - Pain

Frequency dependency of therapeutic efficacy in dorsal root ganglion stimulation for neuropathic pain

Authors: G. S. Piedade, S. Gillner, P. S. McPhillips, J. Vesper, P. J. Slotty

Published in: Acta Neurochirurgica | Issue 4/2022

Abstract

Background

The influence of the stimulation frequency on the outcomes of dorsal root ganglion stimulation (DRG-S) to treat pain is not well understood. It is assumed that specific neural components dedicated to different tasks in the DRG can be preferably influenced at specific frequencies. The identification of frequencies designed for the type of pain and the ratio of neuropathic versus nociceptive pain might improve overall pain control and open new indications in DRG-S.

Method

We report on a randomized double-blind clinical trial with a crossover design. Patients with a permanent DRG-S system underwent phases of stimulation with 20 Hz, 40 Hz, 60 Hz, 80 Hz, and sham in a randomized order. Each phase lasted for 4 days and was followed by a 2-day washout period. Pain intensity and quality of life were assessed with visual analog scale (VAS), McGill Pain Questionnaire (MPQ), EQ-5D, and Beck Depression Inventory (BDI). Analgesics intake was assessed.

Results

Overall 19 patients were included in the study. CRPS was the most frequent pain etiology (7). Five patients had a PainDetect score of 12 or lower at baseline. The mean VAS before the system was implanted was 8.6 and 3.9 at the baseline. Pain intensity was reduced to 3.7 by the stimulation with 20 Hz but increased with higher frequencies reaching 5.8 at 80 Hz. A significant difference among the groups was shown over all variables examined (VAS, MPQ, EQ-5D, BDI). The best results were seen at 20 Hz for all variables, including the smallest increase in pain medication consumption.

Conclusions

The choice of the stimulation frequency shows a clear influence on pain reduction and quality of life. Lower stimulation frequencies seem to be most effective in neuropathic pain. Further studies are required to determine whether specific frequencies should be preferred based on the condition treated.

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Title: Frequency dependency of therapeutic efficacy in dorsal root ganglion stimulation for neuropathic pain
Authors: G. S. Piedade
S. Gillner
P. S. McPhillips
J. Vesper
P. J. Slotty
Publication date: 01-04-2022
Publisher: Springer Vienna
Keywords: Neuropathic Pain
Complex Regional Pain Syndrome
Complex Regional Pain Syndrome
Published in: Acta Neurochirurgica / Issue 4/2022
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-022-05161-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Frequency dependency of therapeutic efficacy in dorsal root ganglion stimulation for neuropathic pain

Abstract

Background

Method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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