Artikel
Restored laser evoked potentials in chronic-neuropathic pain patients under dorsal root ganglion stimulation treatment – mere electrical phenomenon or neural plasticity?
Wiederherstellung Laser evozierter Potentiale bei chronischen neuropathischen Schmerzen durch Dorsalganglienstimulation – nur ein elektrisches Phänomen oder Neuroplastizität?
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Veröffentlicht: | 4. Juni 2021 |
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Gliederung
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Objective: Dorsal root ganglion stimulation (DRGS) relieves pain in patients with chronic neuropathic pain. However, its neurophysiological mechanism remains unclear. We used laser evoked potentials (LEP) to verify our hypothesis that the recovery of LEP may reflect DRGS induced neuroplasticity of the nociceptive system.
Methods: Nine patients (mean age 56.8 years, range 36 to 77 years, 2 females) diagnosed with chronic neuropathic pain were enrolled in the study. We measured each patient’s LEP at the painful limb and contralateral healthy limb on the first, fourth, and seventh day after implantation of the DRGS system. Their pain assessment was performed according to the numeric rating scale (NRS) at the same time.
Results: The LEP amplitude of the N2-P2 complex in these patients showed a significant increase at day 7 compared to day 1 (Z = -2.666, p = 0.008) and day 4 (Z = -2.547, p = 0.011), respectively. There was no significant difference in the N2-P2 complex amplitude between the ON and OFF states of the DRGS. Compared to the preoperative assessment, the patients’ NRS significantly decreased after 1 day (p = 0.007), 4 days (p = 0.007), and 7 days (p = 0.007).
Conclusion: In this study, we showed that under DRGS treatment, the LEP of neuropathic pain patients recovers within a period of 7 days. The DRGS treatment has a lasting rather than a temporary effect. DRGS can also significantly reduce the NRS in patients with chronic neuropathic pain. This reflects DRGS induced neuroplasticity in the nociceptive system.