OBJECTIVES: Spinal cord stimulation (SCS) is an efficacious therapy for chronic neuropathic pain whose precise mechanism of action is unclear. Mediators produced by glial and immune cells are now believed to modulate neuronal transmission and promote chronic neuropathic pain. We postulated a relationship between cerebrospinal fluid (CSF) concentrations of neuroimmune mediators and SCS. MATERIALS AND METHODS: We measured CSF concentrations of the chemokine, monocyte chemotactic protein-1 (MCP-1), and the growth factors, brain-derived neurotrophic factor (BDNF), and vascular endothelial growth factor (VEGF) and tested for relationships with stimulation parameters and clinical response in nine patients with failed back surgery syndrome (FBSS). RESULTS: Patients with FBSS had higher CSF concentrations of BDNF (p = 0.01) and MCP-1 (p = 0.0001) than matched controls. CSF concentrations of BDNF and VEGF correlated with reported pain (p = 0.04). Five minutes of SCS resulted in a reduction in median VEGF concentrations (p = 0.01). CONCLUSIONS: Patients with FBSS have altered CSF levels of BDNF and MCP-1. CSF VEGF correlates with pain and is reduced by SCS. This may offer novel insights into both the mechanism of action of SCS in FBSS and the variation in clinical response that may be encountered.
OBJECTIVES: Spinal cord stimulation (SCS) is an efficacious therapy for chronic neuropathic pain whose precise mechanism of action is unclear. Mediators produced by glial and immune cells are now believed to modulate neuronal transmission and promote chronic neuropathic pain. We postulated a relationship between cerebrospinal fluid (CSF) concentrations of neuroimmune mediators and SCS. MATERIALS AND METHODS: We measured CSF concentrations of the chemokine, monocyte chemotactic protein-1 (MCP-1), and the growth factors, brain-derived neurotrophic factor (BDNF), and vascular endothelial growth factor (VEGF) and tested for relationships with stimulation parameters and clinical response in nine patients with failed back surgery syndrome (FBSS). RESULTS: Patients with FBSS had higher CSF concentrations of BDNF (p = 0.01) and MCP-1 (p = 0.0001) than matched controls. CSF concentrations of BDNF and VEGF correlated with reported pain (p = 0.04). Five minutes of SCS resulted in a reduction in median VEGF concentrations (p = 0.01). CONCLUSIONS: Patients with FBSS have altered CSF levels of BDNF and MCP-1. CSF VEGF correlates with pain and is reduced by SCS. This may offer novel insights into both the mechanism of action of SCS in FBSS and the variation in clinical response that may be encountered.
Authors: Jacob Caylor; Rajiv Reddy; Sopyda Yin; Christina Cui; Mingxiong Huang; Charles Huang; Rao Ramesh; Dewleen G Baker; Alan Simmons; Dmitri Souza; Samer Narouze; Ricardo Vallejo; Imanuel Lerman Journal: Bioelectron Med Date: 2019-06-28
Authors: Anne-Li Lind; Di Wu; Eva Freyhult; Constantin Bodolea; Titti Ekegren; Anders Larsson; Mats G Gustafsson; Lenka Katila; Jonas Bergquist; Torsten Gordh; Ulf Landegren; Masood Kamali-Moghaddam Journal: PLoS One Date: 2016-02-25 Impact factor: 3.240
Authors: Sarah E Giron; Martin F Bjurstrom; Charles A Griffis; F Michael Ferrante; Irene I Wu; Andrea L Nicol; Tristan R Grogan; Joseph F Burkard; Michael R Irwin; Elizabeth Crabb Breen Journal: Pain Med Date: 2018-05-01 Impact factor: 3.637