• Youngwon Youn, Heather Smith, Brian Morris, Charles Argoff, and Julie G Pilitsis.
• Department of Neurosurgery, Albany Medical Center, Albany, N.Y., USA.
• Stereotact Funct Neurosurg. 2015 Jan 1; 93 (5): 355-9.

BackgroundHigh-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.ObjectiveWe compare the effects of HFS and traditional SCS on quantitative sensory testing parameters to provide insight into how HFS modulates the nervous system.MethodsUsing 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.ResultsHFS 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.ConclusionHFS 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.© 2015 S. Karger AG, Basel.

26 keywords...

hide…