Matthias Hubert Morgalla1, Marcos Fortunato de Barros Filho1,2,3, Bankim Subhash Chander1,2, Surjo Raphael Soekadar2,4, Marcos Tatagiba1, Guilherme Lepski1,3. 1. Department of Neurosurgery, University of Tuebingen, Tuebingen, Germany. 2. Applied Neurotechnology Laboratory, Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany. 3. Division of Functional Neurosurgery, School of Medicine, Universidade de São Paulo, São Paulo, Brazil. 4. Clinical Neurotechnology Laboratory, Neuroscience Research Center (NWFZ) & Department of Psychiatry and Psychotherapy, Charité - University Medicine Berlin, Berlin, Germany.
Abstract
OBJECTIVES: Dorsal root ganglion stimulation (DRGS) has been used successfully against localized neuropathic pain. Nevertheless, the effects of DRGS on pain processing, particularly at the cortical level, remain largely unknown. In this study, we investigated whether positive responses to DRGS treatment would alter patients' laser-evoked potentials (LEP). METHODS: We prospectively enrolled 12 adult patients with unilateral localized neuropathic pain in the lower limbs or inguinal region and followed them up for six months. LEPs were assessed at baseline, after one month of DRGS, and after six months of DRGS. Clinical assessment included the Numerical Rating Scale (NRS), Brief Pain Inventory (BPI), SF-36, and Beck Depression Inventory (BDI). For each patient, LEP amplitudes and latencies of the N2 and P2 components on the deafferented side were measured and compared to those of the healthy side and correlated with pain intensity, as measured with the NRS. RESULTS: At the one- and six-month follow-ups, N2-P2 amplitudes were significantly greater and NRS scores were significantly lower compared with baseline (all p's < 0.01). There was a negative correlation between LEP amplitudes and NRS scores (rs = -0.31, p < 0.10). CONCLUSIONS: DRGS is able to restore LEPs to normal values in patients with localized neuropathic pain, and LEP alterations are correlated with clinical response in terms of pain intensity.
OBJECTIVES: Dorsal root ganglion stimulation (DRGS) has been used successfully against localized neuropathic pain. Nevertheless, the effects of DRGS on pain processing, particularly at the cortical level, remain largely unknown. In this study, we investigated whether positive responses to DRGS treatment would alter patients' laser-evoked potentials (LEP). METHODS: We prospectively enrolled 12 adult patients with unilateral localized neuropathic pain in the lower limbs or inguinal region and followed them up for six months. LEPs were assessed at baseline, after one month of DRGS, and after six months of DRGS. Clinical assessment included the Numerical Rating Scale (NRS), Brief Pain Inventory (BPI), SF-36, and Beck Depression Inventory (BDI). For each patient, LEP amplitudes and latencies of the N2 and P2 components on the deafferented side were measured and compared to those of the healthy side and correlated with pain intensity, as measured with the NRS. RESULTS: At the one- and six-month follow-ups, N2-P2 amplitudes were significantly greater and NRS scores were significantly lower compared with baseline (all p's < 0.01). There was a negative correlation between LEP amplitudes and NRS scores (rs = -0.31, p < 0.10). CONCLUSIONS: DRGS is able to restore LEPs to normal values in patients with localized neuropathic pain, and LEP alterations are correlated with clinical response in terms of pain intensity.
Authors: Frank J P M Huygen; Jan Willem Kallewaard; Harold Nijhuis; Liong Liem; Jan Vesper; Marie E Fahey; Bram Blomme; Matthias H Morgalla; Timothy R Deer; Robyn A Capobianco Journal: Neuromodulation Date: 2019-11-15
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