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Papers of the Week
Maximal Analgesic Effect Attained by the Use of Objective Neurophysiological Measurements With Closed-Loop Spinal Cord Stimulation.
Authors
Levy RM, Mekhail NA, Kapural L, Gilmore CA, Petersen EA, Goree JH, Pope JE, Costandi SJ, Kallewaard JW, Thomson S, Gilligan C, AlFarra T, Broachwala MY, Chopra H, Hunter CW, Rosen SM, Amirdelfan K, Falowski SM, Li S, Scowcroft J, Lad SP, Sayed D, Antony A, Deer TR, Hayek SM, Guirguis MN, Boeding RB, Calodney AK, Bruel B, Buchanan P, Soliday N, Duarte RV, Leitner A, Staats PSAbstract
Spinal cord stimulation (SCS) has been challenged by the lack of neurophysiologic data to guide therapy optimization. Current SCS programming by trial-and-error results in suboptimal and variable therapeutic effects. A novel system with a physiologic closed-loop feedback mechanism using evoked-compound action potentials enables the optimization of physiologic neural dose by consistently and accurately activating spinal cord fibers. We aimed to identify neurophysiologic dose metrics and their ranges that resulted in clinically meaningful treatment responses.