Comparison of Neural Activity in Chronic Pain Patients during Tonic and Burst Spinal Cord Stimulation Using Fluorodeoxyglucose Positron Emission Tomography

Date
2019-04-30
item.page.orcid
Journal Title
Journal ISSN
Volume Title
Publisher
Blackwell Publishing Inc.
item.page.doi
Abstract

Objective: Burst spinal cord stimulation (SCS) is a novel stimulation paradigm that seems to provide better pain relief compared to the classic tonic SCS with minimal paresthesia sensation. Based on source localized electroencephalography and clinical data, it has been proposed that burst stimulation as defined by Dirk De Ridder exerts this greater effect by not only modulating the lateral and the descending pain-inhibitory pathways (similar to tonic SCS) but also modulating the medial pain pathway, which encodes the affective, motivational aspects of pain. Material and Methods: The current study evaluates the supraspinal differences between burst and tonic stimulation with another functional imaging technique, namely fluorodeoxyglucose positron emission tomography (FGD-PET) scanning, in seven patients, who underwent both burst and tonic SCS, to confirm this notion of medial pain pathway modulation. Results: The results of the current FGD-PET study show that burst stimulation, in contrast to tonic stimulation, indeed modulates the dorsal anterior cingulate cortex (i.e., medial pain pathway) more than tonic stimulation. Discussion: Our data suggest an inherent difference in the central neural mechanisms during burst and tonic stimulation, which could potentially alter the patient's perception of pain. ©2019 International Neuromodulation Society

Description
Due to copyright restrictions full text access from Treasures at UT Dallas is restricted to current UTD affiliates (use the provided Link to Article).
Keywords
Gyrus Cinguli, Pain, Positron-Emission Tomography, Spinal Cord Stimulation, Fluorodeoxyglucose
item.page.sponsorship
item.page.rights
©2019 International Neuromodulation Society
Citation
Collections