Department of Anesthesiology, Unit of Pain Medicine, Albert Schweitzer Hospital, Zwijndrecht, The Netherlands.
Department of Pain and Anesthesiology, The James Cook Hospital, Middlesbrough, U.K.
Pain Pract. 2020 Jun;20(5):522-533. doi: 10.1111/papr.12880. Epub 2020 Mar 24.
To identify variables that influence pain reduction following peripheral nerve field stimulation (PNFS) in order to identify a potential responder profile.
Exploratory univariate and multivariate (random forest) analyses were performed separately on 2 randomized controlled trials and a registry; all included patients with chronic back pain, mainly failed back surgery syndrome. An international expert panel judged the clinical relevance of variables to identify responders by consensus.
Variables identified that may help predict PNFS success in patients with back pain include patient and pain characteristics (age, time since onset of pain and spinal surgery, pain medication history, position and size of pain area, pain severity, mixed nociceptive/neuropathic pain, health-related quality of life, depression, functional disability, and leg pain status), implant procedure variables (the number and position of leads, paresthesia coverage, and amount of pain relief during the trial), and programming (number of programs, cathodes, and anodes; pulse rate; pulse width; and percentage of device usage).
While these analyses are exploratory and restricted to a limited sample size, they suggest variables that may play a role in predicting a therapeutic response. These results, however, are informative only and should be cautiously interpreted. Future research to validate the variables in a clinical study is needed.
确定影响周围神经场刺激（PNFS）后疼痛减轻的变量，以确定潜在的应答者特征。
分别对 2 项随机对照试验和 1 项登记处进行了探索性单变量和多变量（随机森林）分析；所有纳入的患者均患有慢性腰痛，主要为失败的腰椎手术综合征。国际专家小组通过共识判断变量对识别应答者的临床相关性。
确定的可能有助于预测腰痛患者 PNFS 成功的变量包括患者和疼痛特征（年龄、疼痛发作和脊柱手术时间、疼痛药物史、疼痛区域的位置和大小、疼痛严重程度、混合伤害感受/神经病理性疼痛、健康相关生活质量、抑郁、功能障碍和腿部疼痛状况）、植入程序变量（导联的数量和位置、感觉异常覆盖范围以及试验期间的疼痛缓解程度）和编程（程序、阴极和阳极的数量；脉冲率；脉冲宽度；和设备使用率的百分比）。
虽然这些分析是探索性的，并且仅限于有限的样本量，但它们表明了可能在预测治疗反应中起作用的变量。然而，这些结果只是信息性的，应谨慎解释。需要进行未来的研究以在临床研究中验证这些变量。
