• Cristy M Schade, John Sasaki, David M Schultz, Nancy Tamayo, Gary King, and Lisa M Johanek.
• Center for Pain Control, Garland, TX, USA; John Sasaki, M.D., Inc., Pomona, CA, USA; Medical Advanced Pain Specialists (MAPS), Applied Research Center, Edina, MN, USA; and Medtronic Neuromodulation, Minneapolis, MN, USA.
• Neuromodulation. 2010 Jul 1;13(3):210-7.

Objectives  Spinal cord stimulation devices control energy by generating either constant voltage (CV) pulses or constant current (CC) pulses. This study aimed to investigate: 1) whether patients feel differences between CV and CC stimulation; 2) if patients prefer CV or CC stimulation.Methods  Fourteen patients blinded to the type of pulse generation received 20 randomized pairs of 15-sec pulse trains (CC-CV, CV-CC, CV-CV, or CC-CC). Patients identified whether the pairs were the same or different, and if they preferred the first or second train.Results  There was no difference in charge-per-pulse input between CV and CC modes. Patients performed at chance level in identifying identical pairs (55.7 ± 24.1% correct, 10 trials), and slightly better in identifying different pairs (67.1 ± 25.2% correct, 10 trials). No patients correctly identified all pairs. Patients were categorized based on their performance in this task. Only three patients fell into a category where preference could be established with some confidence with respect to the group averages. Two of these patients preferred CV, while one patient preferred CC.Conclusion  The lack of patient ability to discriminate in this preliminary investigation suggests that patient preference for a stimulation type should not be the key determining factor in choosing a spinal cord stimulation system.© 2010 International Neuromodulation Society.

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