Goudman Lisa, Jansen Julie, Vets Nieke, De Smedt Ann, Moens Maarten
Department of Neurosurgery, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium.
STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium.
J Clin Med. 2021 Jun 29;10(13):2921. doi: 10.3390/jcm10132921.
The increased awareness of discrepancies between self-reporting outcome measurements and objective outcome measurements within the field of neuromodulation has accelerated the search towards more objective measurements. The aim of this study was to evaluate whether an electronic nose can differentiate between chronic pain patients in whom Spinal Cord Stimulation (SCS) was activated versus deactivated. Twenty-seven patients with Failed Back Surgery Syndrome (FBSS) participated in this prospective pilot study. Volatile organic compounds in exhaled breath were measured with electronic nose technology (Aeonose™) during SCS on and off states. Random forest was used with a leave-10%-out cross-validation method to determine accuracy of discriminating between SCS on and off states. Our random forest showed an accuracy of 0.56, with an area under the curve of 0.62, a sensitivity of 62% (95% CI: 41-79%) and a specificity of 50% (95% CI: 30-70%). Pain intensity scores were significantly different between both SCS states. Our findings indicate that we cannot discriminate between SCS off and on states based on exhaled breath with the Aeonose™ in patients with FBSS. In clinical practice, these findings imply that with a noninvasive electronic nose, exhaled breath cannot be used as an additional marker of the effect of neuromodulation.
在神经调节领域，人们越来越意识到自我报告的结果测量与客观结果测量之间存在差异，这加速了对更客观测量方法的探索。本研究的目的是评估电子鼻能否区分脊髓刺激（SCS）开启和关闭状态下的慢性疼痛患者。27例腰椎手术失败综合征（FBSS）患者参与了这项前瞻性初步研究。在SCS开启和关闭状态下，使用电子鼻技术（Aeonose™）测量呼出气中的挥发性有机化合物。采用随机森林结合留一法交叉验证方法来确定区分SCS开启和关闭状态的准确性。我们的随机森林显示准确率为0.56，曲线下面积为0.62，灵敏度为62%（95%CI：41-79%），特异性为50%（95%CI：30-70%）。两种SCS状态下的疼痛强度评分有显著差异。我们的研究结果表明，在FBSS患者中，使用Aeonose™无法根据呼出气区分SCS关闭和开启状态。在临床实践中，这些结果意味着，对于无创电子鼻而言，呼出气不能用作神经调节效果的额外标志物。
