Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, 410013, China.
Department of Anesthesiology, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, 410028, China.
Ann Clin Transl Neurol. 2024 Jan;11(1):57-66. doi: 10.1002/acn3.51932. Epub 2023 Oct 30.
Spinal cord stimulation (SCS) is an effective method to treat neuropathic pain. It is necessary to identify the responders of SCS analgesia before implantation. The aim of this study is to investigate the relationship between the cortical dynamics and SCS analgesia responders in pain management.
Resting-state EEG recording was performed in patients who underwent short-term implantation of spinal cord stimulation for pain therapy. We then did spectral analysis to capture the pattern of cortical oscillation between neuromodulation therapy analgesia responders and nonresponders.
About 58.3% (14 out of 24) of participants were considered as analgesia responders, with average visual analogue scores reduction of 4.8 ± 1.0 after surgery, and 2.1 ± 0.7 for the nonresponder subgroup, respectively. The alpha oscillation was significantly enhanced in responder cohort compared with nonresponders. We also observed an increasing spectral power of gamma band in responders. Furthermore, the attenuation of pain severity was significantly correlated with the global alpha oscillation activity (r = 0.60, P = 0.002). Likely, positive and significant correlation was found between the pain relief and gamma activity (r = 0.58, P = 0.003).
Distinct pattern of neural oscillation is associated with the analgesic effect of spinal cord stimulation in pain management, enhancement of cortical alpha and gamma oscillation may be a predictor of analgesia responders.
脊髓刺激（SCS）是治疗神经性疼痛的有效方法。在植入前需要确定 SCS 镇痛的应答者。本研究旨在探讨疼痛管理中皮质动力学与 SCS 镇痛应答者之间的关系。
对接受短期脊髓刺激疼痛治疗植入的患者进行静息状态脑电图记录。然后，我们进行了频谱分析，以捕捉神经调节治疗镇痛应答者和非应答者之间皮质振荡的模式。
约 58.3%（24 人中的 14 人）被认为是镇痛应答者，术后平均视觉模拟评分降低 4.8±1.0，非应答者亚组为 2.1±0.7。与非应答者相比，应答者队列中的 alpha 振荡明显增强。我们还观察到应答者的 gamma 波段光谱功率增加。此外，疼痛严重程度的减轻与全局 alpha 振荡活动显著相关（r=0.60，P=0.002）。可能的是，疼痛缓解与 gamma 活动之间存在正显著相关性（r=0.58，P=0.003）。
神经振荡的不同模式与疼痛管理中脊髓刺激的镇痛效果相关，皮质 alpha 和 gamma 振荡的增强可能是镇痛应答者的预测指标。
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