• Neuromodulation · Feb 2015

    Increased contact heat evoked potential stimulation latencies in responders to spinal cord stimulation for painful diabetic polyneuropathy.

    • Wouter A Pluijms, Rachel Slangen, Maarten van Kleef, Elbert A Joosten, and Jos P H Reulen.
    • Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
    • Neuromodulation. 2015 Feb 1;18(2):126-32; discussion 132.

    ObjectivesTo analyze sensory characteristics and small nerve fiber function in patients suffering from painful diabetic polyneuropathy (PDP) and compare outcomes in responders and nonresponders to SCS treatment.MethodsFifteen patients with intractable PDP in the legs were recruited. If trial stimulation resulted in clinically relevant pain relief, a pulse generator was implanted and pain scores were measured after 12 months. Sensory characteristics (modified Inflammatory Neuropathy Cause and Treatment [md-INCAT] sum score) and small nerve fiber function (contact heat evoked potentials, CHEPs) were measured before implantation (D1), and CHEP measurement was repeated after two weeks of trial stimulation (D2). Outcomes in responders (N = 10) and nonresponders (N = 5) to SCS treatment were compared. Data were analyzed using nonparametric statistics.ResultsAt one year, clinically relevant pain relief was achieved in 10 out of 15 patients. The md-INCAT score did not differ between SCS responders and nonresponders (8.0 vs. 5.0; p = 0.59). No differences were found in CHEP outcomes at D1 vs. D2, except for dorsal forearm P2 latency, and the correlation between D1 and D2 CHEP outcomes was high. Volar N2 forearm latency (0.492 vs. 0.434; p < 0.01), dorsal forearm N2 latency (0.518 vs. 0.453; p = 0.04), and dorsal forearm P2 latency (0.660 vs. 0.589; p = 0.04) were increased in SCS responders as compared with SCS nonresponders.ConclusionsFrom this small-scale clinical pilot study we conclude that forearm CHEP latencies are increased in PDP patients who respond to SCS therapy as compared with SCS nonresponders. Before the CHEP latency can be used as a predictor of SCS outcome in PDP patients, a large-scale study is needed.© 2014 Maastricht University Medical Center.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…