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Evaluation of Washout Periods After Dorsal Root Ganglion Stimulation Trial.
Chapman, Kenneth B; Amireh, Ahmad; van Helmond, Noud; Yousef, Tariq A.
Afiliación
  • Chapman KB; The Spine & Pain Institute of New York, New York City, NY, USA; Department of Anesthesiology, New York University Langone Medical Center, New York City, NY, USA; The Zucker School of Medicine at Hofstra/Northwell, New York City, NY, USA; Department of Anesthesiology, Pain, and Palliative Medicin
  • Amireh A; The Spine & Pain Institute of New York, New York City, NY, USA.
  • van Helmond N; The Spine & Pain Institute of New York, New York City, NY, USA; Department of Anesthesiology, Pain, and Palliative Medicine, Radboud University Nijmegen, Nijmegen, The Netherlands.
  • Yousef TA; The Spine & Pain Institute of New York, New York City, NY, USA.
Neuromodulation ; 27(5): 881-886, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38551547
ABSTRACT

OBJECTIVE:

Dorsal root ganglion stimulation (DRG-S) is a novel therapy to treat chronic pain. It has shown efficacy when delivered intermittently, suggesting a delayed washout effect exists. To measure the washout period, and to determine whether there are differences in washout times among different types of treated pain, we measured the time for pain to return at the end of the patients' one-week DRG stimulation trials. MATERIALS AND

METHODS:

Patients who completed a successful DRG-S trial were included. The times until 25% (t25) and 90% (t90) of baseline pain level returned were recorded. The patients were divided into neuropathic, nociceptive, and mixed pain groups for subgroup comparison. t25 and t90 were plotted in the entire cohort and subgroups using reverse Kaplan-Meier plots (failure curves) and compared using a log-rank test.

RESULTS:

In total, 29 consecutive patients were included. Median t25 and t90 times were 7.1 and 19.5 hours, respectively. Median (interquartile range) times were longest for the nociceptive pain group (n = 17) and shortest for the neuropathic pain group (n = 6), with the mixed-pain group (n = 6) in between (t25 7.1 [1.7-19.4], 3.40 [1.4-8.4], and 5.7 [0.8-17.6]; t90, 22.0 [10.7-71.0], 7.6 [3.6-19.8], and 20.9 [14.2-31.2], respectively). t90 times differed significantly by pain type (p = 0.040).

CONCLUSIONS:

This study showed a prolonged washout period after cessation of DRG-S therapy. Washout times vary according to pain type. The observed effects are possibly due to long-term depression of pain signaling and could allow the implementation of alternative stimulation strategies with DRG-S. Further investigations evaluating DRG-S washout times are warranted.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estimulación de la Médula Espinal / Ganglios Espinales / Neuralgia Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Neuromodulation Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estimulación de la Médula Espinal / Ganglios Espinales / Neuralgia Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Neuromodulation Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos