BACKGROUND: High-frequency stimulation (HFS) has recently gained attention as an alternative to parameters used in traditional spinal cord stimulation (SCS). Because HFS is paresthesia free, the gate theory of pain control as a basis of SCS has been called into question. The mechanism of action of HFS remains unclear. OBJECTIVE: We compare the effects of HFS and traditional SCS on quantitative sensory testing parameters to provide insight into how HFS modulates the nervous system. METHODS: Using quantitative sensory testing, we measured thermal detection and pain thresholds and mechanical detection and pressure pain thresholds, as well as vibratory detection, in 20 SCS patients off stimulation (OFF), on traditional stimulation (ON) and on HFS in a randomized order. RESULTS: HFS significantly increased the mechanical detection threshold compared to OFF stimulation (p < 0.001) and traditional SCS (p = 0.01). Pressure pain detection and vibratory detection thresholds also significantly increased with HFS compared to ON states (p = 0.04 and p = 0.01, respectively). In addition, HFS significantly decreased 10- and 40-gram pinprick detection compared to OFF states (both p = 0.01). No significant differences between OFF, ON and HFS states were seen in thermal and thermal pain detection. CONCLUSION: HFS is a new means of modulating chronic pain. The mechanism by which HFS works seems to differ from that of traditional SCS, offering a new platform for innovative advancements in treatment and a greater potential to treat patients by customizing waveforms.
BACKGROUND: High-frequency stimulation (HFS) has recently gained attention as an alternative to parameters used in traditional spinal cord stimulation (SCS). Because HFS is paresthesia free, the gate theory of pain control as a basis of SCS has been called into question. The mechanism of action of HFS remains unclear. OBJECTIVE: We compare the effects of HFS and traditional SCS on quantitative sensory testing parameters to provide insight into how HFS modulates the nervous system. METHODS: Using quantitative sensory testing, we measured thermal detection and pain thresholds and mechanical detection and pressure pain thresholds, as well as vibratory detection, in 20 SCS patients off stimulation (OFF), on traditional stimulation (ON) and on HFS in a randomized order. RESULTS: HFS significantly increased the mechanical detection threshold compared to OFF stimulation (p < 0.001) and traditional SCS (p = 0.01). Pressure pain detection and vibratory detection thresholds also significantly increased with HFS compared to ON states (p = 0.04 and p = 0.01, respectively). In addition, HFS significantly decreased 10- and 40-gram pinprick detection compared to OFF states (both p = 0.01). No significant differences between OFF, ON and HFS states were seen in thermal and thermal pain detection. CONCLUSION: HFS is a new means of modulating chronic pain. The mechanism by which HFS works seems to differ from that of traditional SCS, offering a new platform for innovative advancements in treatment and a greater potential to treat patients by customizing waveforms.
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: Yannick J G M Plantaz; Robert T M van Dongen; Richard L Witkam; Kris C P Vissers; Hans Timmerman Journal: Eur J Pain Date: 2022-06-13 Impact factor: 3.651
Authors: Huan Yang; Timir Datta-Chaudhuri; Sam J George; Bilal Haider; Jason Wong; Tyler D Hepler; Ulf Andersson; Michael Brines; Kevin J Tracey; Sangeeta S Chavan Journal: Bioelectron Med Date: 2022-10-05
Authors: Thomas Kinfe; Nico von Willebrand; Andreas Stadlbauer; Michael Buchfelder; Thomas L Yearwood; Sajjad Muhammad; Shafqat R Chaudhry; Sascha Gravius; Thomas Randau; Klemens Winder; Christian Maihöfner; Nadine Gravius; Walter Magerl Journal: J Transl Med Date: 2020-10-21 Impact factor: 5.531